MR. JEREMY DE WAYNE LONG LMHC, LPC
NPI 1831458561
Counselor - Professional in West Melbourne, FL
NPI Status: Active since May 15, 2012
Contact Information
870 HOLLYWOOD BLVD
WEST MELBOURNE, FL
ZIP 32904
Phone: (800) 438-1772
Fax: (262) 345-5562
- Individual
- Male
- Counselor
- Professional
- Opted-Out Medicare
About JEREMY LONG
This page provides the complete NPI Profile along with additional information for Jeremy Long, a provider established in West Melbourne, Florida with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1831458561 assigned on May 2012. The practitioner's primary taxonomy code is 101YP2500X with license number 5617-125 (WI). The provider is registered as an individual and his NPI record was last updated 6 years ago.
- NPI
- 1831458561
- Provider Name
- MR. JEREMY DE WAYNE LONG LMHC, LPC
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 870 HOLLYWOOD BLVD WEST MELBOURNE, FL 32904
- Location Phone
- (800) 438-1772
- Location Fax
- (262) 345-5562
- Mailing Address
- 630 TEJON AVE SW PALM BAY, FL 32908
- Mailing Phone
- (321) 482-9492
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-15-2012
- Last Update Date
- 08-24-2020
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Jeremy Long opted out of Medicare effective on 09-02-2025 until 09-02-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Secondary Locations
- W175N11120 Stonewood Dr
Germantown, WI 53022
(800) 438-1772 - 690 Friday Rd
Cocoa, FL 32926
(321) 636-9941
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Professional
- Taxonomy Code
- 101YP2500X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 5617-125
- License State
- WI
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | MH 11075 (FL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100057489 | MEDICAID (05) | WI |
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 09-02-2025
Opt-Out End Date: 09-02-2027
Eligible to Order and Refer? No
Reviews for MR. JEREMY DE WAYNE LONG LMHC, LPC
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1831458561, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
WEST MELBOURNE, FL 32904
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1831458561, enumerated as an "individual" on May 15, 2012.
The provider is located at 870 HOLLYWOOD BLVD WEST MELBOURNE, FL 32904 and the phone number is (800) 438-1772.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
