Active NPI
Kathleen Long, PH.D.
- Clinical Psychologist
- Windham, ME
National Provider Identifier
1407821648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS1445
- Practice address
- 508 Gray Rd
Windham, ME 04062-4831 - Phone
- (252) 349-0219
- NPI assigned
- Feb 21, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS1445 | ME | Primary |
Addresses
Primary practice location
508 Gray Rd
Windham, ME 04062-4831
Mailing address
PO Box 6061
Falmouth, ME 04105-6061
Phone (252) 349-0219
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0319V | Other | NC | BLUE CROSS BLUE SHIELD NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170221000431 | ME | Practitioner - Clinical Psychologist | 9638101298 | Practice locations: New Gloucester, ME; Windham, ME |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
508 Gray Rd
Windham, ME 04062-4831
Phone (252) 349-0219
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2424 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559174400000",
"number": "1407821648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6061",
"city": "FALMOUTH",
"state": "ME",
"postal_code": "041056061",
"telephone_number": "252-349-0219",
"fax_number": "252-636-5677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 GRAY RD",
"city": "WINDHAM",
"state": "ME",
"postal_code": "040624831",
"telephone_number": "252-349-0219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "KATHLEEN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-21",
"last_updated": "2019-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ME",
"license": "PS1445",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD NC",
"identifier": "0319V",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Windham, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.