Latanya Buckham

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

013763 Issued in NY

Practice address

205 Hudson St
New York, NY 10013-1803

Phone

(347) 674-0768

NPI assigned

Aug 12, 2021

Sex

Female

Sole proprietor

Yes

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 NY

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

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NY

  Medicare reassignment NPD
• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050
  NPD (past)

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1942975743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 HUDSON ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100131803",
            "telephone_number": "347-674-0768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 HUDSON ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100131803",
            "telephone_number": "347-674-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKHAM",
        "first_name": "LATANYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "013763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Buck, LMHC
• Tessa Buck, PA-C
• Jack Buckanavage
• Laurie Anne Buckenberger, NP
• Lindsay Buckenham, LMSW
• Adam Buckholz, M.D.
• Laura Buckholz, PT, DPT
• Ian David Buckingham, MD
• Barnett Bucklam, D.D.S
• Ronni Sue Bucklan, D.D.S.

• Mental Health Counselor in New York, NY
• Providers in New York, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.