Individual provider Active NPI

Nancy Ignacia Longoria, PHD

  • Marriage & Family Therapist
  • Ontario, OR
National Provider Identifier
1376945089
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
85000189A Issued in IN
Practice address
702 Sunset Dr
Ontario, OR 97914-3121
Phone
(541) 889-9167
NPI assigned
Sep 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 85000189A IN Primary

Addresses

Primary practice location

702 Sunset Dr
Ontario, OR 97914-3121

Mailing address

702 Sunset Dr
Ontario, OR 97914-3121
Phone (541) 889-9167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240116003718 OR Practitioner - Marriage and Family Therapist 9436501335 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
85000189AINMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeways, Inc CurrentSince Jan 1, 2024 Accepting new patients
Lifeways, Inc CurrentSince Jan 1, 2024 Accepting new patients
Lifeways, Inc Current Accepting new patients

Locations

702 Sunset Dr
Ontario, OR 97914
Phone (541) 823-9041

Organizations & group practices 3

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": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1376945089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SUNSET DR",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979143121",
            "telephone_number": "541-889-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 SUNSET DR",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979143121",
            "telephone_number": "541-889-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGORIA",
        "first_name": "NANCY",
        "middle_name": "IGNACIA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "85000189A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OR

Sources for this page

Verify at the official NPI Registry.