Individual provider Active NPI

Kirsten Long

  • Clinical Social Worker
  • Monroeville, PA
National Provider Identifier
1508585910
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW022920 Issued in PA
Practice address
302 Rickey Dr
Monroeville, PA 15146-1304
Phone
(412) 944-5803
NPI assigned
Aug 26, 2022
Last updated
Aug 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW022920 PA Primary

Addresses

Primary practice location

302 Rickey Dr
Monroeville, PA 15146-1304

Mailing address

302 Rickey Dr
Monroeville, PA 15146-1304
Phone (412) 944-5803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230227002181 PA Practitioner - Clinical Social Worker 7618340464 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Dec 10, 2022 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1508585910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 RICKEY DR",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151461304",
            "telephone_number": "412-944-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 RICKEY DR",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151461304",
            "telephone_number": "412-944-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KIRSTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW022920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

Verify at the official NPI Registry.