Individual provider Active NPI

Lavonda Mary Phillip Long

  • Behavior Technician
  • Albuquerque, NM
National Provider Identifier
1962307140
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1904 Alvarado Dr NE Apt D
Albuquerque, NM 87110-5164
Phone
(505) 980-5124
NPI assigned
Oct 8, 2026
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

1904 Alvarado Dr NE Apt D
Albuquerque, NM 87110-5164

Mailing address

1904 Alvarado Dr NE Apt D
Albuquerque, NM 87110-5164
Phone (505) 980-5124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1791417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1962307140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 ALVARADO DR NE APT D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105164",
            "telephone_number": "505-980-5124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 ALVARADO DR NE APT D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105164",
            "telephone_number": "505-980-5124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "LAVONDA",
        "middle_name": "MARY PHILLIP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-08",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.