Individual provider Active NPI

Lateffa Robinson

  • Clinical Psychologist
  • Silver Spring, MD
National Provider Identifier
1245528066
Registry record updated Nov 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
05745 Issued in MD
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, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180531002388 DC Practitioner - Clinical Psychologist 4385911940 Reassigns benefits to 1 organization

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
Psychcare Psychological Services LLCGroup PAC ID 2264660133, 19 clinicians

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

LicenseStateTypeSpecialty
05745MDMDSpecialist

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

Verify at the official NPI Registry.