Individual provider Active NPI

Nityia Lathan, MS

  • Mental Health Counselor
  • West Palm Beach, FL
National Provider Identifier
1508209594
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH9567 Issued in FL
Practice address
1551 Forum PL
Suite 400 D & E
West Palm Beach, FL 33401-2319
Phone
(561) 201-9879
NPI assigned
Apr 10, 2013
Last updated
Apr 10, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH9567 FL Primary

Addresses

Primary practice location

1551 Forum PL
Suite 400 D & E
West Palm Beach, FL 33401-2319

Mailing address

2001 W Blue Heron Blvd
Riviera Beach, FL 33404-5003
Phone (561) 841-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
IMH9567FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Behavioral Health & Wellness LLC Mental Health Current Accepting new patients

Locations

2620 N Australian Ave
Ste 109
West Palm Beach, FL 33407
Phone (561) 900-8639

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": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1508209594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W BLUE HERON BLVD",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334045003",
            "telephone_number": "561-841-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 FORUM PL",
            "address_2": "SUITE 400 D & E",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012319",
            "telephone_number": "561-201-9879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHAN",
        "first_name": "NITYIA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH9567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; 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.