Individual provider Active NPI

Christine Longmire, LCAS, PH.D

  • Addiction (Substance Use Disorder) Counselor
  • Fayetteville, NC
National Provider Identifier
1811033145
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCAS 926 Issued in NC
Practice address
6238 Penfield Dr
Fayetteville, NC 28314-2061
Phone
(910) 728-3420
Fax
(910) 867-7622
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS 926 NC Primary

Addresses

Primary practice location

6238 Penfield Dr
Fayetteville, NC 28314-2061

Mailing address

6238 Penfield Dr
Fayetteville, NC 28314-2061
Phone (910) 728-3420

Other identifiers 1

IdentifierTypeStateIssuer
6111752MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LCAS 926NCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411948800000",
    "number": "1811033145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6238 PENFIELD DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142061",
            "telephone_number": "910-728-3420",
            "fax_number": "910-867-7622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6238 PENFIELD DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142061",
            "telephone_number": "910-728-3420",
            "fax_number": "910-867-7622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGMIRE",
        "first_name": "CHRISTINE",
        "credential": "LCAS, PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2014-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS 926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6111752",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; 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.