Patricia Diane Long-Brohm, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60503508 Issued in WA

Practice address

4215 SW Sullivan St
Seattle, WA 98136-2365

Phone

(785) 865-9645

NPI assigned

Jun 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Patricia Long Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2025 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1770527616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6523 CALIFORNIA AVE SW # B177",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981361833",
            "telephone_number": "785-865-9645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 SW SULLIVAN ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981362365",
            "telephone_number": "785-865-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG-BROHM",
        "first_name": "PATRICIA",
        "middle_name": "DIANE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20819",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60503508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KC",
            "identifier": "32655011",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "LONG",
            "credential": "MSW, LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erika Londres
• Loneliness Isnt Forever
• Ashley Loney, AUD
• Long Chiropractic Center
• Long Life Acupuncture & Herbs, Corp.
• Alexander Ga Leung Long, O.D.
• Alicia Long
• Christopher Long
• Crystal Long
• Dustin Ross Long, M.D.

• Clinical Social Worker in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.