Latonya Balkcom
Individual provider Active NPI Counselor · East Chicago, IN
NPI 1104142652 · NPPES record last updated Apr 8, 2010
Key facts
- NPI
- 1104142652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 3903 Indianapolis Blvd
East Chicago, IN 46312-2555 - Phone
- (219) 398-2555
- NPI assigned
- Apr 8, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
3903 Indianapolis Blvd
East Chicago, IN 46312-2555
Mailing address
3903 Indianapolis Blvd
East Chicago, IN 46312-2555
Other providers in East Chicago, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2010. 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.