ANNETTE LONG (PHD) – Clinical Psychologist, NPI 1467474742

ANNETTE LONG (PHD) is a healthcare provider. based in Pueblo, Colorado. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 676 (CO). The NPI Number for ANNETTE LONG (PHD) is 1467474742

Main info

Female
52 Years Of Experience
Accepts Medicare Assignment
Name
ANNETTE LONG (PHD)
NPI
1467474742
Phone
(719) 564-9039
Address
924 INDIANA AVE
Enumeration Date
24 July 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7195649039
Graduation Year
1974 (52 years ago)
PAC ID
7719975689
Professional Enrollment ID
I20040501000223
Address ID
CO810043747PU924XXAVEX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

747 CLINICAL PSYCHOLOGIST in CO

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Provider Addresses for ANNETTE LONG (PHD)

  • 924, Indiana Avenue, Pueblo, Pueblo County, Colorado, 81004, United States

    PUEBLO, CO 810043747

    Phone: (719) 564-9039

    Fax: (719) 561-8752

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-05-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040501000223IClinical PsychologistCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour23117$0
View full utilization report →

Insurance plans in this area (ZIP 81004)

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Reviews

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Frequently asked questions

What NPI should I save for ANNETTE LONG (PHD)?
Save NPI 1467474742 if you need a stable reference for ANNETTE LONG (PHD).
Does this profile mean ANNETTE LONG (PHD) is currently active?
Yes — ANNETTE LONG (PHD) appears active in the national provider directory.
Does ANNETTE LONG (PHD) list a primary specialty?
If you are matching referrals, note Clinical Psychologist for ANNETTE LONG (PHD). Clinical services aligned with this taxonomy classification.
Where is ANNETTE LONG (PHD)'s primary listing?
We display Pueblo, Colorado because that is what the record indicates for ANNETTE LONG (PHD).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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