Tia Jacqueline Long, M.S.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

6333 Odana Rd
Madison, WI 53719-1170

Phone

(608) 270-2511

NPI assigned

May 20, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1346686201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 4TH ST",
            "city": "BRODHEAD",
            "state": "WI",
            "postal_code": "535201135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 ODANA RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191170",
            "telephone_number": "608-270-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "TIA",
        "middle_name": "JACQUELINE",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-20",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Long, RN
• Kristin Leigh Long, M.D.
• Micah Long, MD
• Sara C. Long, M.D.
• Susan Kay Long, A.T.C.
• Longevity Clinical LTC Associates of Wisconsin, SC
• Ryan Joseph Longfellow, MD
• Lauren Longhenry, AUD, CCC-A
• Joseph Michael Longino
• B Jack Longley, MD

• Marriage & Family Therapist in Madison, WI
• Providers in Madison, WI by specialty
• Marriage & Family Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.