Pamela Carlson Long, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

080434 Issued in IA

Practice address

2550 Middle Rd Ste 602
Bettendorf, IA 52722-3289

Phone

(563) 265-1529

NPI assigned

Apr 25, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 30, 2024 through Oct 30, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1700574092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 N FILLMORE ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041833",
            "telephone_number": "309-714-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 MIDDLE RD STE 602",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223289",
            "telephone_number": "563-265-1529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "PAMELA",
        "middle_name": "CARLSON",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149002897",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "080434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Lobberecht
• Collin Andrew Lodico, PH.D.
• Miriam Loewen, PHARMD
• Kimberly Ann Logsdon, APRN
• Michelle Logsdon
• Elizabeth Lotspeich, PHARMD
• Kara Lovik
• Mark S. Lucas, D.P.M.
• Marie Ludgate, RD, LD, LDN
• Myles Julian Luszczyk, D.O.

• Clinical Social Worker in Bettendorf, IA
• Providers in Bettendorf, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.