Active NPI
Jacqui Long, MS,OTR/L, CHT
- Occupational Therapist
- Bethesda, MD
National Provider Identifier
1720310147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC011331
- Practice address
- 6410 Rockledge Dr Ste 600
Bethesda, MD 20817-1844 - Phone
- (301) 581-8030
- NPI assigned
- Feb 10, 2010
- Last updated
- Apr 25, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 10443 | NC | |
| Occupational Therapist | 225X00000X | OT15730 | FL | |
| Occupational Therapist | 225X00000X | 116098 | TX | |
| Occupational Therapist | 225X00000X | 5201010649 | MI | |
| Occupational Therapist | 225X00000X | OC011331 | PA | Primary |
Addresses
Primary practice location
6410 Rockledge Dr Ste 600
Bethesda, MD 20817-1844
Mailing address
4601 Park Rd
Ste 300
Charlotte, NC 28209-2290
Phone (704) 323-2276
Other names 1
- Jacqui A Lees
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10443 | NC | MD | Pharmacist |
| OT15730 | FL | MD | Occupational Therapist |
| 5201010649 | MI | MD | Occupational Therapist |
| OC011331 | PA | MD | Occupational Therapist |
| 116098 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745539200000",
"number": "1720310147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 PARK RD",
"address_2": "STE 300",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282092290",
"telephone_number": "704-323-2276",
"fax_number": "704-945-7681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6410 ROCKLEDGE DR STE 600",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208171844",
"telephone_number": "301-581-8030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "JACQUI",
"credential": "MS,OTR/L, CHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-10",
"last_updated": "2025-04-25",
"certification_date": "2025-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "10443",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT15730",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "116098",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201010649",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC011331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JACQUI",
"last_name": "LEES",
"middle_name": "A",
"credential": "MS, OTR/L",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.