Active NPI
Latasha Youngblood
- Mental Health Counselor
- Brandenburg, KY
National Provider Identifier
1033610225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2025 Bypass Rd
Brandenburg, KY 40108-1605 - Phone
- (270) 422-3971
- NPI assigned
- Feb 23, 2018
- Last updated
- Feb 23, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2025 Bypass Rd
Brandenburg, KY 40108-1605
Mailing address
2025 Bypass Rd
Brandenburg, KY 40108-1605
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30605018 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bradley Recovery Center | Mental Health | Past | Accepting new patients |
| Graham Family Care LLC | Multi-Specialty | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519344000000",
"number": "1033610225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2025 BYPASS RD",
"city": "BRANDENBURG",
"state": "KY",
"postal_code": "401081605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2025 BYPASS RD",
"city": "BRANDENBURG",
"state": "KY",
"postal_code": "401081605",
"telephone_number": "270-422-3971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGBLOOD",
"first_name": "LATASHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-23",
"last_updated": "2018-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30605018",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brandenburg, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.