Latasha N Bagley, CDCA
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Lima, OH
NPI 1033934716 · NPPES record last updated Nov 19, 2024
Key facts
- NPI
- 1033934716
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CDCA.188867 (OH)
- Practice address
- 2727 Saint Johns Rd Ste D
Lima, OH 45804-4029 - Phone
- (567) 940-9145
- NPI assigned
- Nov 18, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.188867 | OH | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.188867 | OH | Yes |
Addresses
Primary practice location
2727 Saint Johns Rd Ste D
Lima, OH 45804-4029
Mailing address
8444 N 90TH St Ste 100
Scottsdale, AZ 85258-4437
Phone (602) 248-8886
Other providers in Lima, OH
- Jennifer Anita Bacon
- Alekhya Deepthi Badam
- Tysha Bader
- David Paul Bafford
- James E Bagenstose
- Shakeel A Bahadur
- Dorothy Kay Bailey
- Jamie Bailey
- Shelly Bair
- Rajbir Singh Bajwa
All providers in Lima, OH · Addiction (Substance Use Disorder) Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.