Active NPI
Michael Brandon Long, MA
- Counselor
- Fort Mill, SC
National Provider Identifier
1457545097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 2751
- Practice address
- 541 Veloce TRL
Fort Mill, SC 29715-7826 - Phone
- (803) 547-0421
- NPI assigned
- Aug 28, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 2751 | NC | Primary |
Addresses
Primary practice location
541 Veloce TRL
Fort Mill, SC 29715-7826
Mailing address
541 Veloce TRL
Fort Mill, SC 29715-7826
Phone (803) 547-0421
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2751 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188259200000",
"number": "1457545097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 VELOCE TRL",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297157826",
"telephone_number": "803-547-0421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "541 VELOCE TRL",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297157826",
"telephone_number": "803-547-0421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "MICHAEL",
"middle_name": "BRANDON",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-28",
"last_updated": "2007-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NC",
"license": "2751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Mill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.