Active NPI
Lateffa Robinson
- Clinical Psychologist
- Silver Spring, MD
National Provider Identifier
1245528066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 05745
- Practice address
- 12501 Prosperity Dr Ste 310
Silver Spring, MD 20904-1699 - Phone
- (240) 780-8884
- NPI assigned
- Jul 13, 2011
- Last updated
- Nov 22, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 05745 | MD | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
12501 Prosperity Dr Ste 310
Silver Spring, MD 20904-1699
Mailing address
6325 Woodside CT Ste 350
Columbia, MD 21046-1042
Phone (410) 910-9660
Other practice location 1
6325 Woodside Ct Ste 350
Columbia, MD 21046-1042
Phone (443) 910-9660
Other names 1
- Lateffa King
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12501 Prosperity Dr
Suite 310
Silver Spring, MD 20904-1699
Phone (410) 343-9756
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05745 | MD | MD | Specialist |
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": "1310515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606003200000",
"number": "1245528066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6325 WOODSIDE CT STE 350",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210461042",
"telephone_number": "410-910-9660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12501 PROSPERITY DR STE 310",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209041699",
"telephone_number": "240-780-8884"
}
],
"practiceLocations": [
{
"address_1": "6325 Woodside Ct Ste 350",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "MD",
"postal_code": "210461042",
"country_code": "US",
"telephone_number": "443-910-9660",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBINSON",
"first_name": "LATEFFA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-13",
"last_updated": "2020-11-22",
"certification_date": "2020-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "05745",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LATEFFA",
"last_name": "KING",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.