Brandy Latasha Ingram, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW12467 Issued in FL

Practice address

5868 Creek Station Dr
Pensacola, FL 32504-8627

Phone

(850) 478-1244

NPI assigned

Jul 8, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Brandy Latasha Hicks Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1477969707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5868 CREEK STATION DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048627",
            "telephone_number": "850-478-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5868 CREEK STATION DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048627",
            "telephone_number": "850-478-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "BRANDY",
        "middle_name": "LATASHA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "HICKS",
            "middle_name": "LATASHA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Infectious Disease Group, PA
• Infectious Diseases Associates of Northwest Florida PA
• Infectious Diseases Expert Group of NW Florida LLC
• Infinite Developmental Services LLC.
• Craig Andrew Ingermann, PA-C
• Kelly Patton Ingram, CRNA
• Inher Physique LLC
• Bonnie Carol Inkel
• My-Hanh Thi Inman, APRN
• Inner Peace Pensacola LLC

• Clinical Social Worker in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; 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.