Marvin Lionel Long Jr., ED. D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

538 Issued in GA

Practice address

1626 Veterans Blvd
Suite E
Dublin, GA 31021-3576

Phone

(478) 272-1066

Fax

(478) 272-1066

NPI assigned

Dec 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962563106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 VETERANS BLVD",
            "address_2": "SUITE E",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310213576",
            "telephone_number": "478-272-1066",
            "fax_number": "478-272-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 VETERANS BLVD",
            "address_2": "SUITE E",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310213576",
            "telephone_number": "478-272-1066",
            "fax_number": "478-272-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MARVIN",
        "middle_name": "LIONEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "ED. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Lindsey
• Morgan Sierra Lindsey, M.ED., CCC-SLP
• Kimberly G. Livingston, LPN
• Meagan Rae Logue, PHARMD
• Sharon Janella Logue, RRT
• Melinda Jane Long, L.P.C.
• Tammie M Lord, RN
• Kevin James Lords, D.M.D.
• Sam Love, L.P.C.
• Tracy Oliver Lovett, RPT

• Psychologist in Dublin, GA
• Providers in Dublin, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.