Individual provider Active NPI

Anthony Q Long

  • Clinical Social Worker
  • Mountlake Terrace, WA
National Provider Identifier
1700692647
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SC61633838 Issued in WA
Practice address
21907 64TH Ave W Ste 200
Mountlake Terrace, WA 98043-6200
Phone
(405) 503-9336
NPI assigned
Dec 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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 SC61633838 WA Primary

Addresses

Primary practice location

21907 64TH Ave W Ste 200
Mountlake Terrace, WA 98043-6200

Mailing address

100 N Howard St Ste R
Spokane, WA 99201-0508

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

State licenses

LicenseStateTypeSpecialty
SC61633838WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1700692647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST STE R",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21907 64TH AVE W STE 200",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980436200",
            "telephone_number": "405-503-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "ANTHONY",
        "middle_name": "Q",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-05",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61633838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.