Individual provider Active NPI

Latasha Robinson, LPC

  • Professional Counselor
  • Jackson, MS
National Provider Identifier
1649703695
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2938 Issued in MS
Practice address
460 Briarwood Dr
Suite 510
Jackson, MS 39206-3051
Phone
(601) 956-4816
Fax
(601) 956-4817
NPI assigned
Apr 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Professional Counselor 101YP2500X 2938 MS Primary

Addresses

Primary practice location

460 Briarwood Dr
Suite 510
Jackson, MS 39206-3051

Mailing address

5620 Gladewood Dr
Jackson, MS 39211-2608
Phone (601) 966-0154

Other identifiers 1

IdentifierTypeStateIssuer
01670076MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231229001925 MS Practitioner - Mental Health Counselor 4082064241 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2938MSMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

4811 Old Canton Rd
Ste A
Jackson, MS 39211
Phone (228) 707-4340

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

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": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1649703695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 GLADEWOOD DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112608",
            "telephone_number": "601-966-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 BRIARWOOD DR",
            "address_2": "SUITE 510",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392063051",
            "telephone_number": "601-956-4816",
            "fax_number": "601-956-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "LATASHA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-06",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "2938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01670076",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.