Amanda Bales Long, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904010519 Issued in VA

Practice address

1800 Michael Faraday Dr Ste 206
Reston, VA 20190-5312

Phone

(703) 935-0058

NPI assigned

Jun 14, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Boyd Cowan, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Alexandria, VA
  • NPI 1801353719
  NPD (past)
• Dr. Goldberg & Associates

  • Clinical Psychologist
  • Vienna, VA
  • NPI 1437586526
  NPD (past)

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1760976633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3483 LYON PARK CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221921022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MICHAEL FARADAY DR STE 206",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905312",
            "telephone_number": "703-935-0058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5999 Stevenson Ave Ste 405",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223043302",
            "country_code": "US",
            "telephone_number": "703-935-0058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "AMANDA",
        "middle_name": "BALES",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick Liu, DDS, MD
• Liangxuan Liu
• Whitney Susan Livingston, PHD
• Llfaganmd LLC
• Kymberly Logar, LPC
• Geoffrey Stewart Long, M.D.
• Christin S Loudon, RD
• Loudoun Adult Counseling LLC
• Loudoun Community Health Center
• Loudoun Medical Group, PC

• Clinical Social Worker in Reston, VA
• Providers in Reston, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.