Individual provider Active NPI

Kenya Latonya King, PHD

  • Psychologist
  • Tampa, FL
National Provider Identifier
1962980292
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY10101 Issued in FL
Practice address
14502 N Dale Mabry Highway
Tampa, FL 33618-2705
Phone
(813) 402-4020
NPI assigned
Jul 30, 2018
Last updated
Jul 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY10101 FL Primary

Addresses

Primary practice location

14502 N Dale Mabry Highway
Tampa, FL 33618-2705

Mailing address

14210 Cyber PL Apt 301
Tampa, FL 33613-6169
Phone (917) 930-0096

Other practice location 1

14210 Cyber Pl Apt 301
Tampa, FL 33613-6169
Phone (917) 930-0096

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20181221002185 FL Practitioner - Clinical Psychologist 1052656899 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Wellbeing LLC Psychologist CurrentSince Jul 1, 2023 Accepting new patients
Achieve Wellness Group LLC CurrentSince Jul 27, 2018 Accepting new patients
Senior Living Memory Health, Inc. CurrentSince Jun 12, 2025 Accepting new patients

Locations

2000 Lowson Blvd
Delray Beach, FL 33445
Phone (561) 454-2000

16853 NE 2nd Ave
Ste 304
North Miami Beach, FL 33162
Phone (954) 907-1817

3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200

13039 W Linebaugh Ave
Ste 101
Tampa, FL 33626
Phone (352) 515-6914

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1962980292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14210 CYBER PL APT 301",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336136169",
            "telephone_number": "917-930-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14502 N DALE MABRY HIGHWAY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182705",
            "telephone_number": "813-402-4020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14210 Cyber Pl Apt 301",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336136169",
            "country_code": "US",
            "telephone_number": "917-930-0096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "KENYA",
        "middle_name": "LATONYA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY10101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.