Individual provider Active NPI

Latonya Patterson Mangum, MSW, LCSW, LCAS, CCS

  • Clinical Social Worker
  • Knightdale, NC
National Provider Identifier
1780125211
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C011831 Issued in NC
Practice address
103 Plowlan CT
Knightdale, NC 27545-7910
Phone
(919) 271-4459
NPI assigned
Mar 16, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-22975 NC
Clinical Social Worker 1041C0700X C011831 NC Primary

Addresses

Primary practice location

103 Plowlan CT
Knightdale, NC 27545-7910

Mailing address

103 Plowlan CT
Knightdale, NC 27545-7910
Phone (919) 271-4459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20190911000936 NC Practitioner - Clinical Social Worker 6800125238 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

3643 N Roxboro Rd
Durham, NC 27704-2702
Phone (919) 470-8490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCAS-22975NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. CurrentSince Sep 20, 2021 Accepting new patients
Duke University Affiliated Physicians, Inc. Current Accepting new patients
Duke University Health System, Inc. CurrentSince Sep 20, 2021 Accepting new patients
Duke University Affiliated Physicians, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Duke University Affliated Physicians, Inc CurrentSince Jul 1, 2019 Accepting new patients

Locations

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

162 Legacy Oaks Dr
Ste 102
Knightdale, NC 27545
Phone (919) 232-5205

7200 Creedmoor Rd
Ste 208
Raleigh, NC 27613
Phone (919) 327-1650

Organizations & group practices 5

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": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1780125211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 PLOWLAN CT",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457910",
            "telephone_number": "919-271-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 PLOWLAN CT",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457910",
            "telephone_number": "919-271-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUM",
        "first_name": "LATONYA",
        "middle_name": "PATTERSON",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW, LCAS, CCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-22975",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knightdale, NC

Sources for this page

Verify at the official NPI Registry.