DR. JACK MARTIN LONG PH.D. NPI 1447296629

NPI Information

NPI: 1447296629
Provider Name: DR. JACK MARTIN LONG, PH.D.
Classification: Social Worker - 1041C0700X
Specialization: Clinical
Entity Type: Individual
PECOS Registration: Yes
Address: 720C MAIDEN CHOICE LN
CATONSVILLE, MD
ZIP 21228
Phone: (410) 744-5499

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NPI Details

DR. Jack Martin Long, PH.D. is a clinical social worker in Catonsville, MD with 44 years of experience. 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 Martin Long, PH.D. NPI is 1447296629. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

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

The NPI 1447296629 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Psychotherapy, 45 minutes (HCPCS:90834)
Psychotherapy, 1 hour (HCPCS:90837)

The enumeration date for this NPI number is 6/22/2006 and was last updated on 12/12/2011.

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
1	1041C0700X	Social Worker	Clinical	03068	MARYLAND	Yes

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
1	Q292JM	MEDICARE ID-TYPE UNSPECIFIED	MARYLAND
2	R7610001	OTHER	MARYLAND	BC/BS FEDERAL
3	755011100	MEDICAID	MARYLAND
4	276629	OTHER	MARYLAND	MAMSI
5	R7610001	OTHER	MARYLAND	BLUE CHOICE
6	Q292JM	OTHER	MARYLAND	BLUE CROSS/ BLUE SHIELD

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: 3/30/2025

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