Individual provider Active NPI

Debra April Latoak Lee, MSN PMHN APRN B.C.

  • Psychiatric/Mental Health Nurse Practitioner
  • Germantown, MD
National Provider Identifier
1922725837
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024185578 Issued in VA
Practice address
19403 Buckingham Way
Germantown, MD 20874-4665
Phone
(301) 355-9569
NPI assigned
Oct 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024185578 VA Primary

Addresses

Primary practice location

19403 Buckingham Way
Germantown, MD 20874-4665

Mailing address

12774 Wisteria Dr Unit 2724
Germantown, MD 20875-7635
Phone (301) 355-9569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20240409001982 MD Practitioner - Nurse Practitioner 9032575808 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12774 Wisteria Dr
Unit 2724
Germantown, MD 20875-7635
Phone (240) 796-4304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
About a Healthy Brain CurrentSince Feb 19, 2024 Accepting new patients
Living Deliberately CurrentSince Apr 23, 2024 Accepting new patients

Locations

4419 Falls Rd
Baltimore, MD 21211
Phone (410) 262-9894

516 N Rolling Rd
Ste 305
Catonsville, MD 21228
Phone (240) 245-6948

12774 Wisteria Dr
Unit 2724
Germantown, MD 20875
Phone (240) 796-4304

Organizations & group practices 2

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": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1922725837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12774 WISTERIA DR UNIT 2724",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208757635",
            "telephone_number": "301-355-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19403 BUCKINGHAM WAY",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208744665",
            "telephone_number": "301-355-9569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DEBRA",
        "middle_name": "APRIL LATOAK",
        "name_prefix": "Ms.",
        "credential": "MSN PMHN APRN B.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024185578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

Verify at the official NPI Registry.