Octavia Lashawn Landrum, PSY.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PSY26797 Issued in CA

Practice address

1585 3Rd St
Fort Polk, LA 71459-5102

Phone

(337) 531-3922

NPI assigned

Aug 25, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Dr. Octavia Lashawn Garrett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1356574339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6453 LEADBETTER CT APT B",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "714598413",
            "telephone_number": "214-274-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 3RD ST",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "714595102",
            "telephone_number": "337-531-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRUM",
        "first_name": "OCTAVIA",
        "middle_name": "LASHAWN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "UNLICENSED",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY26797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OCTAVIA",
            "last_name": "GARRETT",
            "middle_name": "LASHAWN",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hannah Klein, LCSW
• Julianne Kossman, RN/CCM
• Nicholas Kramer
• Christopher D Laflair, B.S.
• Kellee Sharee Lamb Wemes
• Daniel James Lee, M.D.
• Elise Leisinger, D.O.
• Gwendolyn Janis Lemaire, NP
• Amber M Leon, RD
• Genesis Leon, MD

• Clinical Child & Adolescent Psychologist in Fort Polk, LA
• Providers in Fort Polk, LA by specialty
• Clinical Child & Adolescent Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; 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.