Active NPI
John Wesley Long, PH.D.
- Clinical Psychologist
- Gastonia, NC
National Provider Identifier
1508846213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0463
- Practice address
- 1530 Union Rd Ste a
Gastonia, NC 28054-2201 - Phone
- (704) 861-0271
- Fax
- (704) 861-0374
- NPI assigned
- Jan 19, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0463 | NC | Primary |
Addresses
Primary practice location
1530 Union Rd Ste a
Gastonia, NC 28054-2201
Mailing address
118 Airport Rd
Stanley, NC 28164-1202
Phone (704) 263-0425
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202947200000",
"number": "1508846213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 AIRPORT RD",
"city": "STANLEY",
"state": "NC",
"postal_code": "281641202",
"telephone_number": "704-263-0425",
"fax_number": "704-861-0374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1530 UNION RD STE A",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280542201",
"telephone_number": "704-861-0271",
"fax_number": "704-861-0374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "JOHN",
"middle_name": "WESLEY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-19",
"last_updated": "2008-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "0463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.