Active NPI
Mark E Lattimore, M.DIV, LCASA
- Addiction (Substance Use Disorder) Counselor
- Forest City, NC
National Provider Identifier
1306526348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LCAS-29161
- Practice address
- 143 Old Wagy Rd
Forest City, NC 28043-9466 - Phone
- (828) 447-2477
- NPI assigned
- Jul 24, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCAS-29161 | NC | Primary |
Addresses
Primary practice location
143 Old Wagy Rd
Forest City, NC 28043-9466
Mailing address
191 Walkaloosa Way
Mooresboro, NC 28114-7830
Phone (828) 447-2477
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
| License | State | Type | Specialty |
|---|---|---|---|
| LCAS-29161 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690156800000",
"number": "1306526348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "191 WALKALOOSA WAY",
"city": "MOORESBORO",
"state": "NC",
"postal_code": "281147830",
"telephone_number": "828-447-2477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "143 OLD WAGY RD",
"city": "FOREST CITY",
"state": "NC",
"postal_code": "280439466",
"telephone_number": "828-447-2477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATTIMORE",
"first_name": "MARK",
"middle_name": "E",
"credential": "M.DIV, LCASA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-07-24",
"last_updated": "2023-07-24",
"certification_date": "2023-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "LCAS-29161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest City, NC
- Jane D. Kirkpatrick, M.D.
- Curtis Koone, PHARMD
- Matthew William Kramer, DO
- Margaret Chesser Krusch, PA
- Lonnie W Lassiter II, M.D.
- Mark Thomas Edward Lattimore, LMHCA
- Gretchen A. Lawrence, DPM
- Paul Layman, PA
- Leaps & Bounds Therapetuic Solutions Inc. (Leaps & Bounds Therapeutic Solutions Inc.)
- Leaps & Bounds Therapeutic Solutions Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.