Individual provider Active NPI

Latoya Natasha Bendolph, PSY.D.

  • Clinical Psychologist
  • Washington, DC
National Provider Identifier
1114087657
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY1000383 Issued in DC
Practice address
3000 Connecticut Ave NW
Suite 134
Washington, DC 20008-2509
Phone
(202) 503-6052
NPI assigned
Dec 12, 2006
Last updated
Feb 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY1000383 DC Primary

Addresses

Primary practice location

3000 Connecticut Ave NW
Suite 134
Washington, DC 20008-2509

Mailing address

1318 Michigan Ave NE
Washington, DC 20017-3805
Phone (203) 449-3570

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY1000383DCMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1114087657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 MICHIGAN AVE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200173805",
            "telephone_number": "203-449-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CONNECTICUT AVE NW",
            "address_2": "SUITE 134",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200082509",
            "telephone_number": "202-503-6052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDOLPH",
        "first_name": "LATOYA",
        "middle_name": "NATASHA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1000383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.