Individual provider Active NPI

Douglas Moore Long, PH.D.

  • Clinical Psychologist
  • Cranston, RI
National Provider Identifier
1750731592
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS01564 Issued in RI
Practice address
1170 Pontiac Ave
Cranston, RI 02920-7944
Phone
(401) 500-0424
NPI assigned
Jun 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS01564 RI Primary

Addresses

Primary practice location

1170 Pontiac Ave
Cranston, RI 02920-7944

Mailing address

420 Scrabbletown Rd Ste a
North Kingstown, RI 02852-3638
Phone (401) 268-5333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
South County Psychiatry LLC Clinical CurrentSince Oct 1, 2023 Accepting new patients
Rhode Island Hospital Clinical PastSince Aug 8, 2020 Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

1170 Pontiac Ave
Cranston, RI 02920
Phone (401) 500-0424

420 Scrabbletown Rd
Ste A
North Kingstown, RI 02852
Phone (401) 268-5333

47 Danielson Pike
North Scituate, RI 02857
Phone (401) 258-5419

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1750731592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SCRABBLETOWN RD STE A",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028523638",
            "telephone_number": "401-268-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 PONTIAC AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029207944",
            "telephone_number": "401-500-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "DOUGLAS",
        "middle_name": "MOORE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-13",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS01564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.