Individual provider Active NPI

Latrell Williams-Elliott, LC16135

  • Counselor
  • Cambridge, MD
National Provider Identifier
1316661671
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LC16135 Issued in MD
Practice address
403 High St
Cambridge, MD 21613-1804
Phone
(443) 225-5780
NPI assigned
Sep 30, 2022
Last updated
Dec 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LC16135 MD Primary

Addresses

Primary practice location

403 High St
Cambridge, MD 21613-1804

Mailing address

713 Rosemont Ave
Cambridge, MD 21613-2131
Phone (267) 730-0360

Other names 1

  • Latrell Elliott Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20260108004427 MD Practitioner - Mental Health Counselor 0446736433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

120 Banjo LN
Centreville, MD 21617-1002

713 Rosemont Ave
Cambridge, MD 21613-2131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC16135MDMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Corsica River Mental Health Service, Inc. CurrentSince Oct 13, 2025 Accepting new patients
Corsica River Mental Health Services, Inc. Past Accepting new patients

Locations

403 High St
Cambridge, MD 21613
Phone (443) 225-5780

120 Banjo Ln
Centreville, MD 21617
Phone (410) 758-2211

332 N Main St
Federalsburg, MD 21632
Phone (410) 479-0511

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1316661671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 ROSEMONT AVE",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216132131",
            "telephone_number": "267-730-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 HIGH ST",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131804",
            "telephone_number": "443-225-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS-ELLIOTT",
        "first_name": "LATRELL",
        "credential": "LC16135",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-30",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "LC16135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATRELL",
            "last_name": "ELLIOTT",
            "credential": "LC16135",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Cambridge, MD

Sources for this page

Verify at the official NPI Registry.