Active NPI
Latisha Marie Gathers-Hutchins, PSY.D.
- Clinical Child & Adolescent Psychologist
- Dayton, OH
National Provider Identifier
1790117836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- P.7054
- Practice address
- 1 Childrens PLZ
Dayton, OH 45404-1815 - Phone
- (937) 641-3401
- Fax
- (937) 641-3066
- NPI assigned
- Jul 31, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 7054 | OH | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | P.7054 | OH | Primary |
Addresses
Primary practice location
1 Childrens PLZ
Dayton, OH 45404-1815
Mailing address
1 Childrens PLZ
Dayton, OH 45404-1815
Phone (937) 641-3000
Other practice location 1
76 Remick Blvd
Springboro, OH 45066
Phone (937) 641-3401
Other practice location 2
3333 W Tech Rd
Miamisburg, OH 45342-0955
Phone (937) 641-3401
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0220150 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7054 | OH | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633824000000",
"number": "1790117836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CHILDRENS PLZ",
"city": "DAYTON",
"state": "OH",
"postal_code": "454041815",
"telephone_number": "937-641-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS PLZ",
"city": "DAYTON",
"state": "OH",
"postal_code": "454041815",
"telephone_number": "937-641-3401",
"fax_number": "937-641-3066"
}
],
"practiceLocations": [
{
"address_1": "76 Remick Blvd",
"address_purpose": "LOCATION",
"city": "Springboro",
"state": "OH",
"postal_code": "45066",
"country_code": "US",
"telephone_number": "937-641-3401",
"fax_number": "937-641-3066",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3333 W Tech Rd",
"address_purpose": "LOCATION",
"city": "Miamisburg",
"state": "OH",
"postal_code": "453420955",
"country_code": "US",
"telephone_number": "937-641-3401",
"fax_number": "937-641-3066",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GATHERS-HUTCHINS",
"first_name": "LATISHA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-31",
"last_updated": "2021-10-10",
"certification_date": "2021-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "7054",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "OH",
"license": "P.7054",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0220150",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.