Individual provider Active NPI

Lateasha Skinner, LPC

  • Professional Counselor
  • Columbus, GA
National Provider Identifier
1124486972
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC008283 Issued in GA
Practice address
3228 University Ave Ste 103
Columbus, GA 31907-7201
Phone
(762) 207-8218
NPI assigned
Feb 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC008283 GA Primary

Addresses

Primary practice location

3228 University Ave Ste 103
Columbus, GA 31907-7201

Mailing address

3228 University Ave Ste 103
Columbus, GA 31907-7201
Phone (762) 207-8218

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

State licenses

LicenseStateTypeSpecialty
LPC008283GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Life Source LLC Professional CurrentSince Nov 3, 2019 Accepting new patients
The Life Source Group Inc Professional Current Accepting new patients
Lma Community Based Consultants, LLC Professional Current Accepting new patients

Locations

3228 University Ave
Ste 103
Columbus, GA 31907
Phone (762) 207-8218

1425 Wynnton Rd
Ste A
Columbus, GA 31906
Phone (706) 780-6332

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1124486972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3228 UNIVERSITY AVE STE 103",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319077201",
            "telephone_number": "762-207-8218",
            "fax_number": "706-400-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3228 UNIVERSITY AVE STE 103",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319077201",
            "telephone_number": "762-207-8218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "LATEASHA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.