Individual provider Active NPI

Latraya Denean Cobb, MA, LLP

  • Clinical Psychologist
  • Detroit, MI
National Provider Identifier
1922302041
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301013979 Issued in MI
Practice address
707 W Milwaukee St
Detroit, MI 48202-2943
Phone
(313) 344-9099
NPI assigned
Jan 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6361000375 MI
Clinical Psychologist 103TC0700X 6301013979 MI Primary

Addresses

Primary practice location

707 W Milwaukee St
Detroit, MI 48202-2943

Mailing address

707 W Milwaukee St
Detroit, MI 48202-2943
Phone (313) 344-9099

Other identifiers 1

IdentifierTypeStateIssuer
6361000375OtherMILLP

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Detroit Direct

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6301013979MIMDClinical Psychologist
6361000375MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1922302041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 W MILWAUKEE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022943",
            "telephone_number": "313-344-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 W MILWAUKEE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022943",
            "telephone_number": "313-344-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "LATRAYA",
        "middle_name": "DENEAN",
        "name_prefix": "Ms.",
        "credential": "MA, LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-04",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361000375",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LLP",
            "identifier": "6361000375",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Detroit",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "707 W Milwaukee St",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.