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SAMUEL ROBERT LONG LISW
NPI 1821587395
Social Worker - Clinical in Moraine, OH

Active since May 09, 2018PECOS Enrolled
5350 LAMME RD, MORAINE, OH 45439(937) 534-4627 Get Directions Write a Review

NPPES record last updated: March 2, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 2, 2025, May 9, 2018 (2 updates tracked since 2018).

About Samuel Robert Long Lisw NPPES

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

SAMUEL ROBERT LONG LISW (NPI 1821587395) is an individual clinical provider in Moraine, Ohio, licensed in Ohio (I.2406033) and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1821587395
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameSAMUEL ROBERT LONGCredential: LISW
Location Address5350 LAMME RDMoraine, OH 45439-3215
Mailing Address1658 Fauver AveDayton, OH 45410-3217 · (937) 204-5015
Phone(937) 534-4627
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateMay 9, 2018
Last NPPES UpdateMarch 2, 20252 updates tracked since enumeration
NPPES CertifiedMarch 2, 2025
✔ NPI 1821587395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in OH · I.2406033
Definition
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.
5350 LAMME RD, Moraine, OH 45439
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, MedMutual, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Robert Long Lisw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9133612435
PECOS Enrollment IDI20251204003183
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.

Medicare Billing Reassignment

Medicare enrollment records show Samuel Long reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sondermind Provider Network LLC
1,105 mi
Clinical
1738 WYNKOOP ST STE 303
Denver, CO 80202
  • Reassigned Medicare billing, Ohio enrollment
  • 313 clinicians in this Medicare group
NPI 1760854442 (844) 843-7279

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45439 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.34 – $166.65
Typical copayment $0.00 (range $13.58 – $41.66)
Most-billed visit code NA
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. JAMIE WEN-WAM CHU MD
Psychiatry & Neurology (Psychiatry)
5350 LAMME RD
MORAINE, OH 45439
Montgomery County (937) 534-4632
LIESL JADE JACOBS MD
Psychiatry & Neurology (Psychiatry)
5350 LAMME RD
MORAINE, OH 45439
Montgomery County (937) 534-4651
MS. BEVERLY J COBB CNP
Nurse Practitioner (Psychiatric/Mental Health)
5350 LAMME RD
DAYTON, OH 45439
Montgomery County (937) 534-4600
JAMES C BARCLAY MD
Psychiatry & Neurology (Psychiatry)
5350 LAMME RD
MORAINE, OH 45439
Montgomery County (937) 534-4632
DR. CHRISTOPHER J HASSELTINE M.D.
Psychiatry & Neurology (Psychiatry)
5350 LAMME RD
MORAINE, OH 45439
Montgomery County (937) 534-4620
MICHELLE NICOLE BONNET MD
Psychiatry & Neurology (Psychiatry)
5350 LAMME RD
MORAINE, OH 45439
Montgomery County (937) 534-4620
C. TODD ANDERSON, MD, LLC
Psychiatry & Neurology (Psychiatry)
5350 LAMME RD
MORAINE, OH 45439
Montgomery County (937) 534-4600
SUSAN ALLISON SNARE PCC
Counselor (Mental Health)
5350 LAMME RD
MORAINE, OH 45439
Montgomery County (937) 534-4632

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Long's NPI number?

The NPI number for Samuel Long is 1821587395. It was assigned to this individual provider in the NPPES registry on May 9, 2018.

Where is Samuel Long located?

Samuel Long practices at 5350 Lamme Rd, Moraine, OH 45439. The listed phone number is (937) 534-4627.

What is Samuel Long's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Samuel Long enrolled in Medicare?

Yes. Samuel Long is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Samuel Long's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Long reassigns Medicare benefits to Sondermind Provider Network LLC (Denver, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samuel Long's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samuel Long accept?

Health plans from Anthem Blue Cross and Blue Shield, MedMutual and UnitedHealthcare list Samuel Long as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samuel Long was last updated on March 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.