Karlisha J Lattibeaudere, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904010988 Issued in VA

Practice address

15941 Donald Curtis Dr Ste 200
Woodbridge, VA 22191-4257

Phone

(703) 792-7800

Fax

(703) 792-5699

NPI assigned

Apr 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1063975373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15941 DONALD CURTIS DR STE 200",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221914257",
            "telephone_number": "703-792-7800",
            "fax_number": "703-792-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15941 DONALD CURTIS DR STE 200",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221914257",
            "telephone_number": "703-792-7800",
            "fax_number": "703-792-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTIBEAUDERE",
        "first_name": "KARLISHA",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Lynne Lashbaugh
• Taher S Lashkeri, MD
• Yovanis Lasso, LMFT
• Babur Bari Lateef, M.D.
• Keith Lathrop, CRNA
• Daniel Lawrence, PT, DPT, CMT
• Richard Lee Layfield III, MD
• Nicole Theresa Layman, RN
• Lazer Focuz Care LLC
• Ada Iris Lazo

• Clinical Social Worker in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.