Dr Stephanie Marie Long, PHD, MSCP, ABPP is a medicare enrolled "Psychologist - Clinical" provider in Providence Forge, Virginia. Her current practice location is
3530 N Courthouse Rd, Providence Forge, Virginia. You can reach out to her office (for appointments etc.) via phone at
(804) 409-7525.
Dr Stephanie Marie Long is licensed to practice in Virginia (license number 810007571) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1407125511.
Healthcare Provider's Profile
| Full Name | Dr Stephanie Marie Long |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 3530 N Courthouse Rd, Providence Forge, Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1407125511
- Provider Enumeration Date: 12/19/2011
- Last Update Date: 01/11/2023
Medicare PECOS Information:
- PECOS PAC ID: 2769629351
- Enrollment ID: I20130520000608
Medical Identifiers
Medical identifiers for Dr Stephanie Marie Long such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407125511 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 04975 (Maryland) | Secondary |
| 103TP0016X | Psychologist - Prescribing (medical) | 311244 (Louisiana) | Secondary |
| 103TC0700X | Psychologist - Clinical | 810007571 (Virginia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Stephanie Marie Long is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Stephanie Marie Long, PHD, MSCP, ABPP
3530 N Courthouse Rd,
Providence Forge, VA 23140-3408
Ph: (804) 409-7525 | Dr Stephanie Marie Long, PHD, MSCP, ABPP
3530 N Courthouse Rd,
Providence Forge, VA 23140-3408
Ph: (804) 409-7525 |
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