Mary Beth Long

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP-6563 Issued in OH

Practice address

225 Lincoln St SW
Hartville, OH 44632-9382

Phone

(330) 877-4276

Fax

(330) 877-4738

NPI assigned

May 22, 2014

Last updated

May 22, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mary Beth Rogers Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1902218126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 LINCOLN ST SW",
            "city": "HARTVILLE",
            "state": "OH",
            "postal_code": "446329382",
            "telephone_number": "330-877-4276",
            "fax_number": "330-877-4738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 LINCOLN ST SW",
            "city": "HARTVILLE",
            "state": "OH",
            "postal_code": "446329382",
            "telephone_number": "330-877-4276",
            "fax_number": "330-877-4738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP-6563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SP-6563",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "ROGERS",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary C Koberlein, L.D./N.
• Lindsay Kolencik, PHARMD
• Jean Anne Lang, D.O.
• Galina Legky
• Sandra M Leonardi, L.P.N.
• Tricia Loper, RN
• Marc Glassman Inc (Marcs)
• Tonya Marie May
• Lindsay Mae Millard, LISW
• Eileen Joan Miller

• Speech-Language Pathologist in Hartville, OH
• Providers in Hartville, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; 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.