Individual provider Active NPI

Lisa Joy Long, LCSW-C

  • Clinical Social Worker
  • New Market, MD
National Provider Identifier
1942363429
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12602 Issued in MD
Practice address
11670 Old National Pike Ste 103
New Market, MD 21774-6123
Phone
(301) 865-2226
Fax
(301) 865-6720
NPI assigned
Dec 18, 2006
Last updated
Nov 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12602 MD Primary

Addresses

Primary practice location

11670 Old National Pike Ste 103
New Market, MD 21774-6123

Mailing address

12003 Cregger Rd
Keymar, MD 21757-8131
Phone (301) 325-7989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20050713001113 MD Practitioner - Clinical Social Worker 5597791269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Maryland School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11670 Old National Pike
Suite 103
New Market, MD 21774-6123
Phone 3018652226302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12602MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Linganore Counseling and Wellness, LLC Clinical CurrentSince Nov 24, 2021 Accepting new patients
Linganore Counseling and Wellness, LLC Clinical CurrentSince Nov 24, 2021 Accepting new patients

Locations

11670 Old National Pike
Ste 103
New Market, MD 21774
Phone (301) 865-2226

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1942363429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12003 CREGGER RD",
            "city": "KEYMAR",
            "state": "MD",
            "postal_code": "217578131",
            "telephone_number": "301-325-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11670 OLD NATIONAL PIKE STE 103",
            "city": "NEW MARKET",
            "state": "MD",
            "postal_code": "217746123",
            "telephone_number": "301-865-2226",
            "fax_number": "301-865-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "LISA",
        "middle_name": "JOY",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Market, MD

Sources for this page

Verify at the official NPI Registry.