Active NPI
Talisha Long, MS CCC-SLP
- Speech-Language Pathologist
- San Diego, TX
National Provider Identifier
1982048120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 102193
- Practice address
- 204 S Dr Ee Dunlap St
San Diego, TX 78384-2802 - Phone
- (361) 279-4041
- NPI assigned
- Apr 18, 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 102193 | TX | Primary |
Addresses
Primary practice location
204 S Dr Ee Dunlap St
San Diego, TX 78384-2802
Mailing address
152 E County Road 2140
Kingsville, TX 78363-8909
Phone (361) 522-6056
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102193 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366243200000",
"number": "1982048120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 E COUNTY ROAD 2140",
"city": "KINGSVILLE",
"state": "TX",
"postal_code": "783638909",
"telephone_number": "361-522-6056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 S DR EE DUNLAP ST",
"city": "SAN DIEGO",
"state": "TX",
"postal_code": "783842802",
"telephone_number": "361-279-4041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "TALISHA",
"credential": "MS CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-18",
"last_updated": "2013-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "102193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.