Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samuel Robert Long, LISW

Individual provider Clinical Social Worker · NPI 1821587395

Samuel Robert Long, LISW is a Clinical Social Worker in Moraine, Ohio. Qualified in 2019, 7 years ago. Practices as a sole proprietor. Licensed in Ohio.

Years since qualifying
7
Licensed in
OH
In the registry since
2018
What do these letters mean?
LISW — Licensed Independent Social Worker
A social worker licensed to practise independently.

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Practice location Address checks out

5350 Lamme Rd
Moraine, OH 45439-3215
Phone: (937) 534-4627
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence I.2406033 (OH)

Record details

NPI number1821587395
Entity typeIndividual (Type 1)
GenderMale
Credentials LISW
Sole proprietorYes
NPI enumeratedMay 9, 2018
Last updated in NPPESMarch 2, 2025
Certification dateMarch 2, 2025
Mailing address1658 Fauver Ave, Dayton, OH 45410-3217

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated

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