LBM Pmhnp

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

LBM PMHNP

Practice address

109 Ceja Way
St Augustine, FL 32095-4852

Phone

(402) 813-3716

NPI assigned

Mar 15, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Latishsa Blanchard, APRN

Title

President

Phone

(402) 813-3716

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1346825015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CEJA WAY",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320954852",
            "telephone_number": "402-813-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CEJA WAY",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320954852",
            "telephone_number": "402-813-3716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LBM PMHNP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "BLANCHARD",
        "authorized_official_first_name": "LATISHSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-813-3716",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL DRIVERS LICENSE",
            "identifier": "B452-533-77-542-0",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "B452-533-77-542-0",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mstish34@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "personal email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "109 Ceja Way",
            "city": "St Augustine",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320954852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sam Lawless, MSW
• Curtis L Lawrence, LCSW
• Amy Layh, LMHC
• Laurence Layne, LMT
• Nokomis Natavia Lazenberry
• Jenny Le, NP
• Shirley N Leadem, M.D.
• Deirdre Leake, MD
• Leah Lear, APRN
• Learning My Way ABA, LLC

• Adult Mental Health Clinic/Center in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.