NPIMap

Organization Active NPI

Long Integrated Psychiatric Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Middle River, MD
National Provider Identifier
1790366193
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LONG INTEGRATED PSYCHIATRIC SERVICES LLC
Practice address
11560 Crossroads Cir
Middle River, MD 21220-2885
Phone
(410) 508-0722
NPI assigned
Apr 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Authorized official

Name
Angela Long, CRNPNPI 1720458706
Title
Owner
Phone
(410) 508-0722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

11560 Crossroads Cir
Middle River, MD 21220-2885

Mailing address

11560 Crossroads Cir Ste 102
Middle River, MD 21220-2885

Other names 1

  • Long Integrated Psychiatric Services Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210426000026 MD Part B Supplier - Clinic/Group Practice 9436567831 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Baltimore, MD; Middle River, MD

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Long Integrated Psych Serv4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11560 Crossroads Cir
Middle River, MD 21220
Phone (410) 508-0722

7652 Belair Rd
Ste A
Nottingham, MD 21236
Phone (410) 508-0722

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1790366193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11560 CROSSROADS CIR STE 102",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11560 CROSSROADS CIR",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202885",
            "telephone_number": "410-508-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG INTEGRATED PSYCHIATRIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-16",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-508-0722",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Integrated Psychiatric Services",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Long Integrated Psychiatric Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Middle River, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.