Taylor Michelle Long, MED, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

271557 Issued in KY

Practice address

117 E Jefferson St
Georgetown, KY 40324-1764

Phone

(859) 224-2273

Fax

(859) 224-4675

NPI assigned

Oct 22, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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.

• Marshall Pediatric Therapy, LLC

  • Pediatric Occupational Therapist
  • Nicholasville, KY
  • NPI 1104198472
  NPD (past)

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

{
    "created_epoch": "1508630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1841701406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WIND HAVEN DR STE 100",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403568010",
            "telephone_number": "859-224-2273",
            "fax_number": "859-224-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E JEFFERSON ST",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241764",
            "telephone_number": "859-224-2273",
            "fax_number": "859-224-4675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3499 Blazer Pkwy Ste 170",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092823",
            "country_code": "US",
            "telephone_number": "859-224-2273",
            "fax_number": "859-224-4675",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "799 E Brannon Rd",
            "address_purpose": "LOCATION",
            "city": "Nicholasville",
            "state": "KY",
            "postal_code": "403566038",
            "country_code": "US",
            "telephone_number": "859-224-2273",
            "fax_number": "859-224-4675",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1013 Center Dr",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "KY",
            "postal_code": "404753841",
            "country_code": "US",
            "telephone_number": "859-224-2273",
            "fax_number": "859-224-4675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "TAYLOR",
        "middle_name": "MICHELLE",
        "credential": "MED, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-22",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-20-45592",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": "271557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATE",
            "identifier": "1-20-45592",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Taylor Little, DMD
• Madison Anne Little, DMD
• Lives Made Stronger Therapy Services, PSC
• Hugh Harrison Loeffler, MD
• Luke Logan, PHARMD
• Anthony Jay Lopez, MD
• LP Georgetown LLC (Signature HealthCARE of Georgetown)
• Amelia Carol Luckett
• Jerry Jason Lyles, D.C
• Lyndsay Dixon Nutrition LLC (Southern Roots Dietitian)

• Behavior Analyst in Georgetown, KY
• Providers in Georgetown, KY by specialty
• Behavior Analyst in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.