Active NPI
Debra D Latham, LCSW
- Clinical Social Worker
- San Angelo, TX
National Provider Identifier
1528064391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- S06774
- Practice address
- 3471 Knickerbocker Rd
Ste 508
San Angelo, TX 76904-8826 - Phone
- (325) 942-7531
- Fax
- (325) 942-7532
- NPI assigned
- Jun 24, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | S06774 | TX | Primary |
Addresses
Primary practice location
3471 Knickerbocker Rd
Ste 508
San Angelo, TX 76904-8826
Mailing address
2942 Sierra Cir
San Angelo, TX 76904-7016
Phone (325) 949-0646
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 117983 | Other | TX | SUPERIOR HEALTHPLAN |
| 125054 | Other | TX | MHN/HMC CLAIMS |
Other names 1
- Debra D Latham
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joe M Jeffers | Clinical | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185408000000",
"number": "1528064391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2942 SIERRA CIR",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769047016",
"telephone_number": "325-949-0646",
"fax_number": "325-942-7532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3471 KNICKERBOCKER RD",
"address_2": "STE 508",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769048826",
"telephone_number": "325-942-7531",
"fax_number": "325-942-7532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATHAM",
"first_name": "DEBRA",
"middle_name": "D",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-24",
"last_updated": "2007-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "S06774",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUPERIOR HEALTHPLAN",
"identifier": "117983",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN/HMC CLAIMS",
"identifier": "125054",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DEBRA",
"last_name": "LATHAM",
"middle_name": "D",
"credential": "LCSW",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in San Angelo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.