Active NPI
Jenna-Ann Lorraine Long
- Clinical Social Worker
- Houston, TX
National Provider Identifier
1861903841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P011993
- Practice address
- 4000 Essex LN Apt 7305
Houston, TX 77027-8124 - Phone
- (919) 904-2427
- NPI assigned
- Oct 18, 2017
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C012923 | NC | |
| Clinical Social Worker | 1041C0700X | 103387 | TX | |
| Clinical Social Worker | 1041C0700X | P011993 | NC | Primary |
Addresses
Primary practice location
4000 Essex LN Apt 7305
Houston, TX 77027-8124
Mailing address
4000 Essex LN Apt 7305
Houston, TX 77027-8124
Phone (919) 904-2427
Other practice location 1
3200 Sugar Pine Trl
Durham, NC 27713-6261
Phone (919) 904-2427
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103387 | Other | TX | LCSW |
| C012923 | Other | NC | LCSW |
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 |
|---|---|---|---|
| C012923 | NC | MD | Clinical Social Worker |
| P011993 | NC | MD | Clinical Social Worker |
| 103387 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670976000000",
"number": "1861903841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 ESSEX LN APT 7305",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770278124",
"telephone_number": "919-904-2427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 ESSEX LN APT 7305",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770278124",
"telephone_number": "919-904-2427"
}
],
"practiceLocations": [
{
"address_1": "3200 Sugar Pine Trl",
"address_purpose": "LOCATION",
"city": "Durham",
"state": "NC",
"postal_code": "277136261",
"country_code": "US",
"telephone_number": "919-904-2427",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LONG",
"first_name": "JENNA-ANN",
"middle_name": "LORRAINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-18",
"last_updated": "2022-12-14",
"certification_date": "2022-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C012923",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "103387",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P011993",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "103387",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "C012923",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.