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DR. JACK M. LONG & ASSOC. P.A. NPI 1144599572


NPI Information

NPI: 1144599572
Provider Name: DR. JACK M. LONG & ASSOC., P.A.
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
720 MAIDEN CHOICE LN
SUITE C
CATONSVILLE, MD
ZIP 21228
Phone: (410) 744-5499
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DR. JACK M. LONG & ASSOC., P.A. is a clinical social worker in Catonsville, MD. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. DR. JACK M. LONG & ASSOC., P.A. NPI is 1144599572. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

720 MAIDEN CHOICE LN
SUITE C
CATONSVILLE, MD
ZIP 21228-940
Phone: (410) 744-5499
Fax: (410) 455-0894

The provider's authorized official is Jack Martin Long .
The authorized official title is Psychotherapist and has the following contact phone number (410) 744-5499.

The enumeration date for this NPI number is 12/13/2011 and was last updated on 12/13/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinical03068MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1755011100OTHERMARYLANDMAMSI
2R7610001OTHERMARYLANDBCBS FEDERAL
3755011100MEDICAIDMARYLAND
4Q292JMOTHERMARYLANDMEDICARE UNSPECIFIED
5R7610001OTHERMARYLANDBLUE CHOICE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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