Individual provider Active NPI

Benjamin Richard Long

  • Marriage & Family Therapist
  • Bedford, NH
National Provider Identifier
1356836597
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
293 Issued in NH
Practice address
173 S River Rd Ste 2
Bedford, NH 03110-6930
Phone
(603) 255-5267
NPI assigned
Jun 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1861 MA
Community Health Worker 172V00000X MA
Marriage & Family Therapist 106H00000X 293 NH Primary

Addresses

Primary practice location

173 S River Rd Ste 2
Bedford, NH 03110-6930

Mailing address

173 S River Rd Ste 2
Bedford, NH 03110-6930
Phone (603) 255-5267

Other practice location 1

360 Merrimack St
Ent H, Suite 120
Lawrence, MA 01843
Phone (978) 688-4830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241030001241 NH Practitioner - Marriage and Family Therapist 3173056009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

173 S River Rd
Suite 2
Bedford, NH 03110-6930
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
293NHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Oct 10, 2024 Accepting new patients
South Bay Mental Health Center, Inc. PastSince Sep 6, 2016 Accepting new patients

Locations

3 Executive Park Dr
Ste 250
Bedford, NH 03110

173 S River Rd
Ste 2
Bedford, NH 03110
Phone (603) 255-5267

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1356836597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 S RIVER RD STE 2",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106930",
            "telephone_number": "603-255-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 S RIVER RD STE 2",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106930",
            "telephone_number": "603-255-5267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 Merrimack St",
            "address_2": "Ent H, Suite 120",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "MA",
            "postal_code": "01843",
            "country_code": "US",
            "telephone_number": "978-688-4830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "BENJAMIN",
        "middle_name": "RICHARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-29",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "1861",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NH",
            "license": "293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

Verify at the official NPI Registry.