Individual provider Active NPI

Latoya Harris

  • Social Worker
  • South Chesterfield, VA
National Provider Identifier
1093323040
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
3220 Loganwood Dr
South Chesterfield, VA 23834
Phone
(804) 243-1352
NPI assigned
Jul 15, 2020
Last updated
Jul 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

3220 Loganwood Dr
South Chesterfield, VA 23834

Mailing address

3220 Loganwood Dr
South Chesterfield, VA 23834
Phone (804) 243-1352

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL SecureHavenTherapy.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241205003865 VA Practitioner - Clinical Social Worker 9537694450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Virginia Commonwealth University, School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9562 Kings Charter Dr
Suite 102
Ashland, VA 23005-8206
Phone (804) 877-1583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heedful Resolutions Behavioral Health Services, LLC CurrentSince Sep 7, 2024 Accepting new patients

Locations

9562 Kings Charter Dr
Ste 102
Ashland, VA 23005
Phone (804) 238-6643

Organizations & group practices 1

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": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1093323040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 LOGANWOOD DR",
            "city": "SOUTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "23834",
            "telephone_number": "804-243-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 LOGANWOOD DR",
            "city": "SOUTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "23834",
            "telephone_number": "804-243-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "LATOYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SecureHavenTherapy.com",
            "affiliation": "N",
            "address_1": "3220 Loganwood Dr",
            "city": "South Chesterfield",
            "state": "VA",
            "country_code": "US",
            "postal_code": "23834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Chesterfield, VA

Sources for this page

Verify at the official NPI Registry.