Latonya Polk

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

1232380 Issued in TX

Practice address

1328 Heritage Blvd
Longview, TX 75605-1472

Phone

(902) 260-0412

Fax

(866) 877-1258

NPI assigned

Dec 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Emmanuel Behavioral Health & Wellness PLLC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Longview, TX
  • NPI 1760338727
  Medicare reassignment NPD Authorized official
• Emmanuel Residential Services

  • Assisted Living Facility
  • Longview, TX
  • NPI 1245509504

  Adult Day Care

  NPD Authorized official
• Emmanuel Living and Activity Centers, LLC

  • Adult Day Care Clinic/Center
  • White Oak, TX
  • NPI 1235746272

  Home Health

  NPD

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1861551814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 HERITAGE BLVD",
            "address_2": "1328 HERITAGE BLVD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756051472",
            "telephone_number": "903-315-8302",
            "fax_number": "866-877-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 HERITAGE BLVD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756051472",
            "telephone_number": "902-260-0412",
            "fax_number": "866-877-1258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 E US Highway 80",
            "address_purpose": "LOCATION",
            "city": "White Oak",
            "state": "TX",
            "postal_code": "756932103",
            "country_code": "US",
            "telephone_number": "903-297-4959",
            "fax_number": "903-297-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "807 S Mobberly Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756022037",
            "country_code": "US",
            "telephone_number": "903-553-0143",
            "fax_number": "903-297-4999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLK",
        "first_name": "LATONYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1232380",
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derin Plemmons
• Charles Clifton Plumley, PTA
• Appifany Plunkett
• Jordan Pointer, RBT
• Yasemin Sultan Polat, DO
• Erika Anne Ponce, R.N.
• Haley Pool, CPNP-PC
• Farzan Adam Poonawala, MD
• Susan Pope
• Jessica Erin Porter, RN

• Psychiatric/Mental Health Clinical Nurse Specialist in Longview, TX
• Providers in Longview, TX by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.