MR. SHANE RAYMOND LONG L.M.F.T.
NPI 1447521356
Marriage & Family Therapist in New Brighton, MN

Q: What is Shane Long's NPI number?

The NPI number for Shane Long is 1447521356. It was assigned to this individual provider in the NPPES registry on January 24, 2012.

Q: What is Shane Long's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Shane Long was last updated on January 24, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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 January 24, 2012PECOS EnrolledAccepts Medicare Assignment

516 MISSION HOUSE LN, NEW BRIGHTON, MN 55112(651) 636-5120(651) 636-5124 Get Directions Write a Review

NPPES record last updated: January 24, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Shane Raymond Long L.m.f.t. NPPES

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

MR. SHANE RAYMOND LONG L.M.F.T. (NPI 1447521356) is an individual marriage & family therapist in New Brighton, Minnesota, licensed in Minnesota (2462) and active in the NPI registry since January 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1447521356

Entity TypeIndividualMale

Primary Taxonomy106H00000X

Provider Legal NameMR. SHANE RAYMOND LONGCredential: L.M.F.T.

Location Address516 MISSION HOUSE LNNew Brighton, MN 55112-2571

Mailing Address516 Mission House LnNew Brighton, MN 55112-2571 · (651) 636-5120 · Fax (651) 636-5124

Phone(651) 636-5120

Fax(651) 636-5124

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateJanuary 24, 2012

✔ NPI 1447521356 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in MN · 2462

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

516 MISSION HOUSE LN, New Brighton, MN 55112

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Shane Raymond Long L.m.f.t. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4183146202

PECOS Enrollment IDI20250318003751

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 7

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

MARY LOU HONSTEAD PH.D., L.P.

Psychologist (Counseling)