Active NPI
Timothy D Long, LMFT
Doing business as Kainos Christian Therapy
- Marriage & Family Therapist
- Beverly Hills, CA
National Provider Identifier
1942600606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 47459
- Legal business name
- TIMOTHY D LONG, LMFT
- Doing business as
- Kainos Christian Therapy
- Practice address
- 329 N Wetherly Dr
Suite 206
Beverly Hills, CA 90211-1605 - Phone
- (310) 203-1510
- NPI assigned
- Sep 1, 2014
- Last updated
- Sep 1, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Timothy D Long, LMFT, LPCC
- Title
- Clinic Director
- Phone
- (310) 203-1510
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPCC1152 | CA | |
| Marriage & Family Therapist | 106H00000X | 47459 | CA | Primary |
Addresses
Primary practice location
329 N Wetherly Dr
Suite 206
Beverly Hills, CA 90211-1605
Mailing address
329 N Wetherly Dr
Suite 206
Beverly Hills, CA 90211-1605
Phone (310) 203-1510
Other names 1
- Kainos Christian Therapy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Locations
329 N Wetherly Dr
Ste 206
Beverly Hills, CA 90211
Phone (310) 203-1510
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409529600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1409529600000",
"number": "1942600606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "329 N WETHERLY DR",
"address_2": "SUITE 206",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902111605",
"telephone_number": "310-203-1510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "329 N WETHERLY DR",
"address_2": "SUITE 206",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902111605",
"telephone_number": "310-203-1510"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TIMOTHY D LONG, LMFT",
"organizational_subpart": "NO",
"enumeration_date": "2014-09-01",
"last_updated": "2014-09-01",
"status": "A",
"authorized_official_last_name": "LONG",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "CLINIC DIRECTOR",
"authorized_official_telephone_number": "310-203-1510",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "LMFT, LPCC"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "LPCC1152",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "47459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Kainos Christian Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2014; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.