Individual provider Active NPI

Latoyia Neal, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bellevue, WA
National Provider Identifier
1851891873
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61148148 Issued in WA
Practice address
14205 SE 36TH St
Ste 100
Bellevue, WA 98006
Phone
(404) 999-4726
NPI assigned
Feb 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NCO-000001 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN216723 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61148148 WA Primary

Addresses

Primary practice location

14205 SE 36TH St
Ste 100
Bellevue, WA 98006

Mailing address

320 Lanier Ave W Ste 200
Fayetteville, GA 30214-7443
Phone (404) 999-4726

Other practice location 1

320 Lanier Ave W
Ste 200
Fayetteville, GA 30214-6388
Phone (404) 999-4726

Other names 1

  • N/a N/a Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20181024000275 GA Practitioner - Nurse Practitioner 2567715428 Reassigns benefits to 2 organizations
I20210518001979 WA Practitioner - Nurse Practitioner 2567715428 Reassigns benefits to 2 organizations
I20251024004182 GA Practitioner - Nurse Practitioner 2567715428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

6505 216TH St SW
Suite 100
Mountlake Terrace, WA 98043-2089
Phone (425) 640-7009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NCO-000001GAMDFamily Nurse Practitioner
AP61148148WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gentle Care Behavioral Health PLLC CurrentSince Jan 27, 2022 Accepting new patients
Personal Recovery Network LLC CurrentSince Sep 2, 2018 Accepting new patients
SGMP Southland LLC CurrentSince Apr 1, 2022 Accepting new patients
Choice Family Medicine, PC Current Accepting new patients
Counseling Services for Wellbeing, Inc. CurrentSince Apr 11, 2022 Accepting new patients
Mindful Therapy Group PC Psychiatric/Mental Health CurrentSince May 12, 2021 Accepting new patients

Locations

320 Lanier Ave W
Ste 200
Fayetteville, GA 30214
Phone (404) 850-0653

320 Lanier Ave W
Fayetteville, GA 30214
Phone (404) 729-3371

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

201 Woodrow Wilson Dr
Valdosta, GA 31602
Phone (229) 241-0041

15811 Ambaum Blvd SW
Ste 110
Burien, WA 98166
Phone (206) 242-8211

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

21907 64th Ave W
Ste 200
Mountlake Terrace, WA 98043
Phone (410) 258-3698

320 NE 97th St
Ste A
Seattle, WA 98115
Phone (206) 323-8113

101 Elliott Ave W
Ste 500
Seattle, WA 98119
Phone (206) 708-6432

Organizations & group practices 6

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": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1851891873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 LANIER AVE W STE 200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147443",
            "telephone_number": "404-999-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14205 SE 36TH ST",
            "address_2": "STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98006",
            "telephone_number": "404-999-4726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Lanier Ave W",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302146388",
            "country_code": "US",
            "telephone_number": "404-999-4726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEAL",
        "first_name": "LATOYIA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "NCO-000001",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN216723",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61148148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "credential": "LATOYIA JACKSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.