Latasha Stanifer-Lumpkin
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · New Brighton, MN
NPI 1336823657 · NPPES record last updated Jun 15, 2023
Key facts
- NPI
- 1336823657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 306689 (MN)
- Practice address
- 1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789 - Phone
- (651) 628-9566
- NPI assigned
- Jun 15, 2023
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 306689 | MN | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 306689 | MN | Yes |
Addresses
Primary practice location
1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Mailing address
4518 Heights Dr
Columbia Heights, MN 55421-3320
Phone (612) 807-6309
Other providers in New Brighton, MN
- Splendor Assisted Living Inc
- Robert Francis Squillace
- St Peter Pharmacy LLC
- Christine Staebell
- Raymond Stafford
- Kieran Stemm
- Wendy Stewart
- Laura Lee Stresow
- Dzenita Subasic
- Mark Elmer Sundby
All providers in New Brighton, MN · Addiction (Substance Use Disorder) Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2023. 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.