Latisha Brockington, LPC-A

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6846 Issued in CT

Practice address

855 Lakewood Rd
Waterbury, CT 06704-5408

Phone

(888) 793-3500

NPI assigned

Nov 1, 2023

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

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: latisha.brockington.p1@direct.wheelerclinic.nextgenshare.com

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1952174948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 HIGH ST",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067703241",
            "telephone_number": "203-490-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 LAKEWOOD RD",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067045408",
            "telephone_number": "888-793-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKINGTON",
        "first_name": "LATISHA",
        "credential": "LPC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-01",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "6846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yolanda Amelia Briones, LCSW
• Jailene Brito
• Susan Broadus
• Alisa Brochu, APRN
• Eugenia M Brockett, LMFT
• Isabel Marguerite Brodersen, PA
• Stephen Brody
• Shantelle Brokaw
• Kathleen Bronsdon
• Kara Elizabeth Brooks, MSW INTERN

• Mental Health Counselor in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.