HALEH NEKOORAD-LONG,M.D.,P.C. (NPI# 1609047430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609047430 |
| Entity Type | Organization |
| Organization Name | HALEH NEKOORAD-LONG,M.D.,P.C. |
| Other Organization Name | COLORADO MOOD AND MEMORY CLINIC |
| Practice Address |
1308 Vivian St Longmont CO 80501-3217 |
| Practice Telephone | 3036829197 |
| Mailing Telephone | 3036829197 |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2008-03-19 |
| Authorized Official Name | DR. HALEH NEKOORAD-LONG (PRESIDENT) |
| Authorized Official Telephone | 3036829197 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 41484 | CO | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | INDIVIDUAL NPI | 1952492571 | 01 |
| Other Name | Type Code |
|---|---|
| Colorado Mood and Memory Clinic | Doing Business As Name - Organization |
| Street Address |
1308 VIVIAN ST |
| City | LONGMONT |
| State | CO |
| Zip Code | 80501-3217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508984709 | Mark Edward Babcock | Social Worker | 1308 Vivian St, Longmont, CO 80501-3217 | 2007-03-26 |
| 1386205888 | Samantha Gehring | Nurse Practitioner | 1308 Vivian St, Longmont, CO 80501-3217 | 2019-06-25 |
| 1104342443 | Front Range Clinic Inc. | Family Medicine | 1308 Vivian St, Longmont, CO 80501-3217 | 2017-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598376774 | Boulder County Public Health | Public Health or Welfare | 515 Coffman Street, Suite 200, Longmont, CO 80501 | 2020-08-12 |
| 1164032827 | Kidstuff Child and Family Counseling, P.C. | Marriage & Family Therapist | 360 15th Ave, Ste. 104, Longmont, CO 80501 | 2020-08-06 |
| 1861036501 | Stateserv Medical of Colorado | Durable Medical Equipment & Medical Supplies | 63 South Pratt Pkwy, Landmont, CO 80501 | 2019-11-06 |
| 1558915090 | Array Clinical and Therapeutic Services | Assistant Behavior Analyst | 451 21st Ave. Suite B, Longmont, CO 80501 | 2019-08-01 |
| 1275195042 | Alisa Marie Schwegerl | Speech-Language Pathologist | 1800 Stroh Place, Longmont, CO 80501 | 2019-07-02 |
| 1295298545 | Jovahna Pena | Counselor | Behavioral Health Group, 850 23rd Ave Unit A, Longmont, CO 80501 | 2019-04-12 |
| 1659845568 | University Physicians Incorporated | Advanced Practice Midwife | 2030 Mountain View Ave Ste 400, Longmont, CO 80501 | 2019-01-14 |
| 1013404714 | Crafted Physical Therapy Pllc | Physical Therapist | 701 Delaware Ave Unit E, Longmont, CO 80501 | 2018-04-18 |
| 1588110860 | Randall Bonnom | Counselor | 420 21st Ave #113, Longmont, CO 80501 | 2016-08-28 |
| 1225401771 | Sowash Optometry Group, PC | Eyewear Supplier (Equipment, not the service) | 1242 S. Hover Street, Suite C200, Longmont, CO 80501 | 2015-11-05 |
| Find all providers in zip 80501 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245655539 | Tatiana Nikolayevna Cone | Specialist | 701 Delaware Ave Unit A, Longmont, CO 80501-6498 | 2014-02-24 |
| 1215220041 | Independent Surgical Assisting, Inc | Specialist | 205 S Main St Ste D, Longmont, CO 80501-1714 | 2011-05-26 |
| 1427368299 | Sally Anne Thompson | Specialist | 3664 Oakwood Drive, Longmont, CO 80503 | 2010-10-14 |
| 1831401538 | Patricia Maynard | Specialist | 1533 Judson Dr, Longmont, CO 80501-2538 | 2010-07-09 |
| 1124357082 | Penny Trevithick | Specialist | 8380 Hygiene Rd, Longmont, CO 80503 | 2009-12-23 |
| 1730313826 | Christie M Baryames | Specialist | 500 Coffman St Ste 115, Longmont, CO 80501-5445 | 2009-05-05 |
| 1497922066 | St. Vrain Ob-gyn Associates, P.C. | Specialist | 2030 Mountain View Ave Ste 440, Longmont, CO 80501-3182 | 2008-05-13 |
| 1568638120 | Wellness Professionals Inc | Specialist | 16 Mt View Ave, Suite 102, Longmont, CO 80501 | 2008-05-05 |
| 1205006533 | Women's Health Wise | Specialist | 630 15th Ave Ste 200, Longmont, CO 80501-2764 | 2008-03-03 |
| 1629260088 | Luz Murillo | Specialist | 630 Lashley St Apt A107, Longmont, CO 80501-5124 | 2007-08-09 |
| Find all providers in LONGMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.