Wanda Kaye Long, LCSW, LIMHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

320,787 Issued in NE

Practice address

1811 W 2ND St Ste 450
Grand Island, NE 68803-5473

Phone

(308) 382-8085

Fax

(308) 382-8085

NPI assigned

Jan 25, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• Ms. Wanda Kaye Long Professional name

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

Clinical Social Worker

Education

Other, 1988

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Family Network

  • Mental Health Counselor
  • Grand Island, NE
  • NPI 1124399464
  Medicare reassignment NPD

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1720134844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 W 2ND ST STE 450",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688035473",
            "telephone_number": "308-382-8085",
            "fax_number": "308-339-0962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 W 2ND ST STE 450",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688035473",
            "telephone_number": "308-382-8085",
            "fax_number": "308-382-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "WANDA",
        "middle_name": "KAYE",
        "name_prefix": "Ms.",
        "credential": "LCSW, LIMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "787",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "511",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "320,787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47072149413",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "82143",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100260989-00",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "8582",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "LONG",
            "middle_name": "KAYE",
            "prefix": "MS.",
            "credential": "LCSW, LIMHP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ashton Loghry, SLP
• Sarah Marie Logue
• Sara A Loman, APRN
• Sydney Claire Lomnes
• Kimberly Long, LPN
• Logan Sophia Longoria
• Leidiesky Lonowski
• Daylin Veronica Lopez Rodriguez
• Adriana Lopez
• Celestina Maria Lopez

• Mental Health Counselor in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.