Individual provider Active NPI

Letisha Hogans, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Marlton, NJ
National Provider Identifier
1043872765
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00994500 Issued in NJ
Practice address
765 Route 70 E BLDG a-101
Marlton, NJ 08053-2341
Phone
(856) 797-4800
NPI assigned
Jul 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 26NR16581800 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00994500 NJ Primary

Addresses

Primary practice location

765 Route 70 E BLDG a-101
Marlton, NJ 08053-2341

Mailing address

81 Village Green LN
Sicklerville, NJ 08081-1629
Phone (609) 422-0923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200427000130 NJ Practitioner - Nurse Practitioner 4082044433 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NR16581800NJMDPsychiatric/Mental Health Registered Nurse
26NJ00994500NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Uhs of Hampton Inc CurrentSince Aug 31, 2023 Accepting new patients
Virtua Medical Group, PA Current Accepting new patients
Creative Change Counseling CurrentSince Jul 23, 2023 Accepting new patients
Virtua Medical Group, PA CurrentSince Nov 8, 2024 Accepting new patients
Evolvenchange, LLC CurrentSince Jul 4, 2021 Accepting new patients
Virtua Medical Group, PA CurrentSince Nov 8, 2024 Accepting new patients
Creative Change Counseling CurrentSince Jul 23, 2023 Accepting new patients
Uhs of Hampton, Inc CurrentSince Aug 31, 2023 Accepting new patients
Rowansom Nmi Osteopathic Manipulative Medicine Past Accepting new patients
Kids in Transition Past Accepting new patients
Rowansom Newjersey Institute for Successful Aging-Geriatric Psychiatry Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

322 E 5th St
Lakewood, NJ 08701
Phone (609) 577-4310

1451 Chews Landing Rd
Ste 207
Laurel Springs, NJ 08021
Phone (856) 341-2208

668 Main St
Lumberton, NJ 08048
Phone (609) 265-7865

100 Century Pkwy
Ste 350
Mount Laurel, NJ 08054
Phone (856) 482-9000

42 E Laurel Rd
Ste 1700
Stratford, NJ 08084
Phone (856) 482-9000

650 Rancocas Rd
Westampton, NJ 08060
Phone (609) 267-7000

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1043872765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 VILLAGE GREEN LN",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080811629",
            "telephone_number": "609-422-0923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 ROUTE 70 E BLDG A-101",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532341",
            "telephone_number": "856-797-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGANS",
        "first_name": "LETISHA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NR16581800",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00994500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.