Latoya Natasha Bendolph, PSY.D.
Individual provider Active NPI Clinical Psychologist · Washington, DC
NPI 1114087657 · NPPES record last updated Feb 15, 2011
Key facts
- NPI
- 1114087657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY1000383 (DC)
- Practice address
- 3000 Connecticut Ave NW
Suite 134
Washington, DC 20008-2509 - Phone
- (202) 503-6052
- NPI assigned
- Dec 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY1000383 | DC | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004945026 | Medicaid | VA |
Other providers in Washington, DC
- Narjes Bencheikh
- Kyle R Benda
- Joanna Bendeck
- Amy Elizabeth Bender
- Jeffrey Bender
- Isatu M Bendu
- Jane Bendu
- Makalay Bendu
- Mariama Bendu
- Zinash Tadesse Beneberu
All providers in Washington, DC · Clinical Psychologist in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.