Queenie V. Lathan, LPCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E0700418SUPV Issued in OH

Practice address

165 E Park Ave
Niles, OH 44446-2352

Phone

(330) 544-8005

Fax

(330) 544-9379

NPI assigned

Aug 7, 2009

Sex

Female

Sole proprietor

Yes

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

Enrolled in OH

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

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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

• Restored Hope Counseling Services LLC

  • Professional Counselor
  • Warren, OH
  • NPI 1811417587
  Medicare reassignment NPD Authorized official
• Cadence Care Network

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Niles, OH
  • NPI 1053928416
  NPD (past)
• Cadence Care Network

  • Adolescent and Children Mental Health Clinic/Center
  • Niles, OH
  • NPI 1558339762
  NPD (past)

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

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1124259122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1063 BRYAN PLACE, NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "44485",
            "telephone_number": "330-219-5892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E PARK AVE",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444462352",
            "telephone_number": "330-544-8005",
            "fax_number": "330-544-9379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 Main Ave SW Ste 903",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444811010",
            "country_code": "US",
            "telephone_number": "330-219-5892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATHAN",
        "first_name": "QUEENIE",
        "middle_name": "V.",
        "name_prefix": "Ms.",
        "credential": "LPCC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0700418SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon Levi Lange
• Debra Langenheim, LPN
• Anthony R Lanier, DO
• Vincent Larubbio
• Allison Lasko
• Caroline Lavernuick
• Alyssa Lawson
• Karrie Burger Lawson, OTR/L
• Lakeya L Lee, PCCR
• Kimberly Lehmenkuler, MSW, LISW

• Professional Counselor in Niles, OH
• Providers in Niles, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.