Latesah Rosha Burks, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C11093 Issued in MS

Practice address

105 Executive Dr
Madison, MS 39110-8496

Phone

(601) 258-0818

NPI assigned

Jun 22, 2024

Last updated

Jun 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 MS

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Coaching Clinic

  dba Chris Webb Counseling Group

  • Mental Health Counselor
  • Madison, MS
  • NPI 1730869892
  Medicare reassignment NPD
• Child Development and Support Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, MS
  • NPI 1366338121
  NPD

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

{
    "created_epoch": "1719014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1700620960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 TRAVIS CV",
            "city": "FLORA",
            "state": "MS",
            "postal_code": "390718908",
            "telephone_number": "601-258-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 EXECUTIVE DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108496",
            "telephone_number": "601-258-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKS",
        "first_name": "LATESAH",
        "middle_name": "ROSHA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-22",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C11093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael R Brown, DPT
• Browning Eyecare PA
• Robert Elliott Browning, MD
• Leigh Farron Buckner, OT
• Kersee Burkett, PT, DPT
• Morgan Lindsey Burnett, O.T.
• McKenzie Russell Burns, AU.D.
• Rebecca Jean Butler, DPT
• Sydney Butler
• BW Medical LLC (MS Express Health)

• Clinical Social Worker in Madison, MS
• Providers in Madison, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2024; 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.