Organization Active NPI

Leslie Delong, PHD, P.C.

  • Counseling Psychologist
  • Lincoln, NE
National Provider Identifier
1366933624
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
576 Issued in NE
Legal business name
LESLIE DELONG, PHD, P.C.
Practice address
650 J St Ste 201
Lincoln, NE 68508
Phone
(402) 413-6430
NPI assigned
May 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Authorized official

Name
Dr. Leslie B Delong, PHDNPI 1700384054
Title
President
Phone
(402) 413-6430

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X 576 NE Primary
Family PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TF0000X 576 NE
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X 576 NE

Addresses

Primary practice location

650 J St Ste 201
Lincoln, NE 68508

Mailing address

650 J St Ste 201
Lincoln, NE 68508-2979
Phone (402) 413-6430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181204000389 NE Part B Supplier - Clinic/Group Practice 8325382294 Receives reassigned benefits from 1 practitioner
Practice locations: Lincoln, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536019200000",
    "number": "1366933624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 J ST STE 201",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685082979",
            "telephone_number": "402-413-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 J ST STE 201",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68508",
            "telephone_number": "402-413-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESLIE DELONG, PHD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-09-04",
        "status": "A",
        "authorized_official_last_name": "DELONG",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-413-6430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "NE",
            "license": "576",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": "NE",
            "license": "576",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NE",
            "license": "576",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.