Amanda Louise Long, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089.0136366 Issued in VT

Practice address

100 E State St Ste 201
Montpelier, VT 05602-3112

Phone

(802) 371-9727

NPI assigned

Feb 19, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Muddy Road Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Montpelier, VT
  • NPI 1053117226
  NPD Authorized official

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1881499101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E STATE ST STE 201",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "056023112",
            "telephone_number": "802-371-9727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E STATE ST STE 201",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "056023112",
            "telephone_number": "802-371-9727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "AMANDA",
        "middle_name": "LOUISE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0136366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lesnak, LCMHC, ATR
• Emily R Levan, APRN,FNP
• Ami Lindemann, LCMHC, LADC, NCC, MA
• Little Moon Counseling LLC
• Lois M Shiozawa
• Jeffrey W Lourie, FNP-C, PMHNP-BC
• Raymond D. Lowe, M.A.
• Rebecca Lowe
• Tracy A Loysen, PH.D.
• Lynch Family Chiropractic LLC

• Clinical Social Worker in Montpelier, VT
• Providers in Montpelier, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.