Latisha Flanigan, CRNP-PMH

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R173061 Issued in MD

Practice address

1420 Joh Ave Ste D
Halethorpe, MD 21227-1073

Phone

(443) 435-0030

NPI assigned

Dec 3, 2024

Last updated

Dec 3, 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 MD

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Iatry Mental Health and Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Halethorpe, MD
  • NPI 1336012137
  Medicare reassignment NPD Authorized official
• 180 Degree Change Behavioral Health

  • Community/Behavioral Health Agency
  • Baltimore, MD
  • NPI 1659037943
  Authorized official Same address or phone
• 180 Degree Change Behavioral Health LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
  • NPI 1093472961
  Authorized official Same address or phone
• 180 Degree Change Behavioral Health LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
  • NPI 1336805613
  Authorized official Same address or phone
• 180 Degree Change Behavioral Health LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
  • NPI 1821755794
  Authorized official Same address or phone

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1710793989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 JOH AVE STE D",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "212271073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 JOH AVE STE D",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "212271073",
            "telephone_number": "443-435-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANIGAN",
        "first_name": "LATISHA",
        "credential": "CRNP-PMH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R173061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Equip Health Services
• Anh Phuong Evardo, PHARMD
• Exceeding Wellness and Support Services, Inc.
• Nwamaka Tagbo Fadahunsi, MD
• Alireza Payman Farsaii, M.D.
• Jennifer Fullem, NP
• Futures Health, Inc
• Mona Kaur Gahunia, D.O.
• Jeffrey Gambel, MD
• Genesis Physiatry Consultants LLC

• Psychiatric/Mental Health Nurse Practitioner in Halethorpe, MD
• Providers in Halethorpe, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.