JENNIFER NICOLE LONGORIA PH.D.
NPI 1154977577
Clinical Neuropsychologist in Charleston, SC

Q: What is Jennifer Longoria's NPI number?

The NPI number for Jennifer Longoria is 1154977577. It was assigned to this individual provider in the NPPES registry on August 12, 2019.

Q: What is Jennifer Longoria's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Longoria was last updated on May 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 12, 2019PECOS Enrolled

171 ASHLEY AVE, CHARLESTON, SC 29425(843) 792-1414 Get Directions Write a Review

NPPES record last updated: May 26, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 26, 2026, Aug 12, 2019 (2 updates tracked since 2019).

On this page

About Jennifer Nicole Longoria Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER NICOLE LONGORIA PH.D. (NPI 1154977577) is an individual clinical neuropsychologist in Charleston, South Carolina, licensed in South Carolina (1986) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154977577

Entity TypeIndividualFemale

Primary Taxonomy103G00000X

Provider Legal NameJENNIFER NICOLE LONGORIACredential: PH.D.

Location Address171 ASHLEY AVECharleston, SC 29425-0100

Mailing Address171 Ashley AveCharleston, SC 29425-0100 · (843) 792-1414

Phone(843) 792-1414

Sole ProprietorNo

Enumeration DateAugust 12, 2019

Last NPPES UpdateMay 26, 20262 updates tracked since enumeration

NPPES CertifiedMay 26, 2026

✔ NPI 1154977577 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in SC · 1986

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

171 ASHLEY AVE, Charleston, SC 29425

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Nicole Longoria Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROLYN REED WORD M.D.

Allergy & Immunology