Active NPI
Latesha Harris-Boyd, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1104533546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 1105 S Western Ave
Chicago, IL 60612-4146 - Phone
- (312) 746-5905
- Fax
- (312) 746-4491
- NPI assigned
- Nov 4, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | IL | Primary |
Addresses
Primary practice location
1105 S Western Ave
Chicago, IL 60612-4146
Mailing address
1105 S Western Ave
Chicago, IL 60612-4146
Phone (312) 746-5905
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62153084771H | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | latesha.harris-boyd@cityofchicago.org | Direct |
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 |
|---|---|---|---|
| Deeply Rooted Therapeutic Solutions LLC | Clinical | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Chicago, IL
- NPI 1013608264
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668384000000",
"number": "1104533546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 S WESTERN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124146",
"telephone_number": "312-746-5905",
"fax_number": "312-746-4491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 S WESTERN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124146",
"telephone_number": "312-746-5905",
"fax_number": "312-746-4491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS-BOYD",
"first_name": "LATESHA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-04",
"last_updated": "2022-11-14",
"certification_date": "2022-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "62153084771H",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "latesha.harris-boyd@cityofchicago.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1105 S Western Ave",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606124146",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.