Active NPI
Susanne K Long, PSYCHOLOGIST
- Psychologist
- Woodbridge, VA
National Provider Identifier
1952743494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 0810-004831
- Practice address
- 13885 Hedgewood Dr
# 245
Woodbridge, VA 22193-7928 - Phone
- (703) 490-0336
- Fax
- (703) 490-4525
- NPI assigned
- Jul 25, 2013
- Last updated
- Nov 26, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0810-004831 | VA | Primary |
Addresses
Primary practice location
13885 Hedgewood Dr
# 245
Woodbridge, VA 22193-7928
Mailing address
13885 Hedgewood Dr
Woodbridge, VA 22193-7928
Phone (703) 490-0336
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2021 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810-004831 | VA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385424000000",
"number": "1952743494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13885 HEDGEWOOD DR",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221937928",
"telephone_number": "703-490-0336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13885 HEDGEWOOD DR",
"address_2": "# 245",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221937928",
"telephone_number": "703-490-0336",
"fax_number": "703-490-4525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "SUSANNE",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-25",
"last_updated": "2013-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VA",
"license": "0810-004831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.