Jessica Lynn Long, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60253462 Issued in WA

Practice address

6816 W Rio Grande Ave Ste D
Kennewick, WA 99336-7659

Phone

(509) 737-9009

Fax

(509) 737-9010

NPI assigned

Oct 2, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jessica Lynn Perry Former name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1891946406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6816 W RIO GRANDE AVE STE D",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367659",
            "telephone_number": "509-737-9009",
            "fax_number": "509-737-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6816 W RIO GRANDE AVE STE D",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367659",
            "telephone_number": "509-737-9009",
            "fax_number": "509-737-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-02",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60253462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GH57134",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "PERRY",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Gage Lockhart, LMHC
• Jose Luis Loera, M.D.
• Vienna Dee Ann Loften, NP-C
• Ren'Ee Elizabeth Logman
• Angela Long, RN
• Chad Longaker, M.ED. LMHC
• Daniel Longhorn
• Miriam N/a Longoria, BSW
• Chevelle A Loomis
• Sonika Loona, MD

• Clinical Psychologist in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.