Michael Thomas Long, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS018844 Issued in PA

Practice address

255 S 17TH St Ste 804
Philadelphia, PA 19103-6208

Phone

(720) 339-5526

NPI assigned

Sep 27, 2019

Last updated

May 4, 2024By the provider in NPPES

Sex

Male

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

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• AIDS Care Group

  • Clinic/Center
  • Chester, PA
  • NPI 1477592400

  Single Specialty

  Medicare reassignment NPD
• AIDS Care Group

  dba Eddystone Community Pharmacy

  • Pharmacy
  • Eddystone, PA
  • NPI 1871913327
  NPD

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714780800000",
    "number": "1790336998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST STE 804",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036208",
            "telephone_number": "203-339-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST STE 804",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036208",
            "telephone_number": "720-339-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-27",
        "last_updated": "2024-05-04",
        "certification_date": "2024-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS018844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Long, M.S., C.G.C.
• Judith A. Long, M.D.
• Lauren Long
• Lisa M Long, CRNP
• Meghan Long
• Mollie Anne Long, CRNP
• Sarah S. Long, M.D.
• Savoun Long, DO
• Stephanie Beth Long, MSW, LCSW
• Suzanne S Long, M.D.

• Clinical Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.