Individual provider Active NPI

Latoya Mone Harris-Freeman, MS, CRC, LPC, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Douglasville, GA
National Provider Identifier
1083972566
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
4867 Kim CT
Douglasville, GA 30135-2659
Phone
(252) 495-0410
NPI assigned
May 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CRC #00114192 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X 2153 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X C0232 GA
Mental Health Counselor 101YM0800X LPC009729 GA
Mental Health Counselor 101YM0800X 8904 NC
Mental Health Counselor 101YM0800X A8904 NC
Professional Counselor 101YP2500X LPC009729 GA
Professional Counselor 101YP2500X 8904 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X NC Primary

Addresses

Primary practice location

4867 Kim CT
Douglasville, GA 30135-2659

Mailing address

4867 Kim CT
Douglasville, GA 30135-2659
Phone (252) 495-0410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
CRC #00114192NCMDCounselor
C0232GAMDAddiction (Substance Use Disorder) Counselor
A8904NCMDMental Health Counselor
LPC009729GAMDProfessional Counselor
8904NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1083972566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4867 KIM CT",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352659",
            "telephone_number": "252-495-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4867 KIM CT",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352659",
            "telephone_number": "252-495-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS-FREEMAN",
        "first_name": "LATOYA",
        "middle_name": "MONE",
        "name_prefix": "Ms.",
        "credential": "MS, CRC, LPC, LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-02",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "CRC #00114192",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "2153",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "C0232",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC009729",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "8904",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A8904",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009729",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "8904",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.