Active NPI
Douglas Moore Long, PH.D.
- Clinical Psychologist
- Cranston, RI
National Provider Identifier
1750731592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS01564
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South County Psychiatry LLC | Clinical | Current | Accepting new patients |
| Rhode Island Hospital | Clinical | Past | 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.
-
- General Acute Care Hospital
- Providence, RI
- NPI 1972768174
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.