Individual provider Active NPI

Latarsha Rene Lawrence, M.S EARLY CHILDHOOD

  • Intellectual & Developmental Disabilities Psychologist
  • Brockton, MA
National Provider Identifier
1174893630
Registry record updated Dec 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
Practice address
1115 W Chestnut St
Brockton, MA 02301-7501
Phone
(770) 337-6593
NPI assigned
Dec 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X Primary

Addresses

Primary practice location

1115 W Chestnut St
Brockton, MA 02301-7501

Mailing address

29 Westmore Rd
Boston, MA 02126-1539
Phone (770) 337-6593

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1325203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1174893630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 WESTMORE RD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021261539",
            "telephone_number": "770-337-6593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 W CHESTNUT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017501",
            "telephone_number": "770-337-6593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "LATARSHA",
        "middle_name": "RENE",
        "name_prefix": "Ms.",
        "credential": "M.S EARLY CHILDHOOD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-30",
        "last_updated": "2011-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.