Shane Raymond Long, L.M.F.T.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2462 Issued in MN

Practice address

516 Mission House LN
New Brighton, MN 55112-2571

Phone

(651) 636-5120

Fax

(651) 636-5124

NPI assigned

Jan 24, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Marriage and Family Therapist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chris Frank CounselingGroup PAC ID 2961924071, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Chris Frank Counseling

  • Professional Counselor
  • Columbia Heights, MN
  • NPI 1477995629
  Medicare reassignment Care Compare group NPD
• North Central Ministry Development Center, Inc.

  • Counseling Psychologist
  • New Brighton, MN
  • NPI 1164711735
  NPD (past)

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

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1447521356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 MISSION HOUSE LN",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551122571",
            "telephone_number": "651-636-5120",
            "fax_number": "651-636-5124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 MISSION HOUSE LN",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551122571",
            "telephone_number": "651-636-5120",
            "fax_number": "651-636-5124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "SHANE",
        "middle_name": "RAYMOND",
        "name_prefix": "Mr.",
        "credential": "L.M.F.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-24",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Ljung
• Shirell Denise Locke
• Lindsey K Locken, PA-C
• Ajda Lommen, MSW, LICSW
• Long Lake Family Denistry
• Heather Lucas, PHD, LP
• Mackenzie Marie Lucier, LADC
• Luella'S House of Care, LLC
• Kari Wiggins Lukken, OTR/L
• Jacob Charles Lusk, LPCC

• Marriage & Family Therapist in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.

Verify at the official NPI Registry.