Jenni Rebecca Longo, MSW, LISW, LCDCIII

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2002089 Issued in OH

Practice address

163 N Sandusky St Ste 205
Delaware, OH 43015-1763

Phone

(614) 259-8737

NPI assigned

Oct 14, 2016

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Maryhaven Inc

  • Addiction (Substance Use Disorder) Registered Nurse
  • Delaware, OH
  • NPI 1538676317
  NPD (past)
• Maryhaven Inc.

  • Community/Behavioral Health Agency
  • Columbus, OH
  • NPI 1245290436
  NPD (past)

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1750832762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 N SANDUSKY ST STE 205",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151763",
            "telephone_number": "614-259-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 N SANDUSKY ST STE 205",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151763",
            "telephone_number": "614-259-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGO",
        "first_name": "JENNI",
        "middle_name": "REBECCA",
        "name_prefix": "Mrs.",
        "credential": "MSW, LISW, LCDCIII",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-14",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "001203",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S27811",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2002089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0282079",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lifestyle Resources
• Suzanne H Lin, D.O
• James Edward Little, MA, LSW
• Reina S Little
• Joseph J Longenbaker
• Amanda N Lortz
• Lotus Behavior Analysis Therapy
• Shelly Sue Louden, RPH
• Hariklia Louvakis, MD
• Madison E Love

• Clinical Social Worker in Delaware, OH
• Providers in Delaware, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.