Active NPI
Susannah Long, LMFT-A
- Marriage & Family Therapist
- Greenville, SC
National Provider Identifier
1861047037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 7051
- Practice address
- 109 Laurens Road
Building 4 Ste D
Greenville, SC 29607 - Phone
- (864) 387-3342
- NPI assigned
- Aug 5, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 7051 | SC | Primary |
Addresses
Primary practice location
109 Laurens Road
Building 4 Ste D
Greenville, SC 29607
Mailing address
PO Box 9474
Greenville, SC 29604-9474
Phone (610) 324-7689
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7051 | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564963200000",
"number": "1861047037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9474",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296049474",
"telephone_number": "610-324-7689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 LAURENS ROAD",
"address_2": "BUILDING 4 STE D",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "29607",
"telephone_number": "864-387-3342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "SUSANNAH",
"credential": "LMFT-A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-05",
"last_updated": "2019-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "SC",
"license": "7051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.