Latarsha Nicole Bronaugh, LPCC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

7066 Stillwater Blvd N
Oakdale, MN 55128-3937

Phone

(651) 777-5222

NPI assigned

Jun 6, 2016

Sex

Female

Sole proprietor

No

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 MN

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

Specialty

Mental Health Counselor

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Law

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 and National Provider Directory roles.

• Canvas Health, Inc.

  • Mental Health Counselor
  • Oakdale, MN
  • NPI 1922051325
  Medicare reassignment NPD
• Northeast Youth & Family Services

  • Community Health Clinic/Center
  • White Bear Lake, MN
  • NPI 1073098810
  NPD (past)
• Northeast Youth & Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shoreview, MN
  • NPI 1639275852
  NPD (past)

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1902255441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7066 STILLWATER BLVD N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551283937",
            "telephone_number": "651-777-5222",
            "fax_number": "833-207-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7066 STILLWATER BLVD N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551283937",
            "telephone_number": "651-777-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONAUGH",
        "first_name": "LATARSHA",
        "middle_name": "NICOLE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zayit Bravo
• Laurie Lee Breidel
• Kelly Christina Bretson, MSW, LICSW
• Margaret Hope Breuer
• Bristol Hospice - Minnesota LLC
• Amy Marie Brown, MA, LMFT
• Charles William Bruchu, DDS
• Lauri Ann Brunello, MA, LPCC
• Delaney Lynn Budge
• Maria Ariella Burgesen, CNA, HHA

• Counselor in Oakdale, MN
• Providers in Oakdale, MN by specialty
• Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.