Kerrilynn J Latta, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-19734 Issued in AZ

Practice address

11225 N 28TH Dr Ste a-10214
Phoenix, AZ 85029-5606

Phone

(623) 203-5151

Fax

(480) 718-7487

NPI assigned

Aug 17, 2021

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

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Satinder S. Purewal, M.D. LLC

  • Psychiatry Physician
  • Glendale, AZ
  • NPI 1528128311
  Medicare reassignment NPD
• Talk It Out Therapy LLC

  • Community/Behavioral Health Agency
  • Glendale, AZ
  • NPI 1639888738
  NPD Authorized official
• Sahara Wellness Center LLC

  • Adult Mental Health Clinic/Center
  • Glendale, AZ
  • NPI 1568040723
  NPD (past)

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1700552114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11225 N 28TH DR STE A-10214",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850295606",
            "telephone_number": "623-203-5151",
            "fax_number": "480-718-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11225 N 28TH DR STE A-10214",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850295606",
            "telephone_number": "623-203-5151",
            "fax_number": "480-718-7487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTA",
        "first_name": "KERRILYNN",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-19734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latins Home LLC
• Marc Murray Lato, M.D.
• Melissa A. Latona, PA
• Victoria Bedigian Latour, M.S CCC SLP
• Lauren Latshaw, FNP-BC
• Paul Thomas Latterman, MD
• Maryann Therese Latus, PH.D.
• Allison Cullen Latzo, RN, CSN, BSN
• Joseph Latzo, PA-C
• Frederick T Lau, DDS

• Clinical Social Worker in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.