Latoya Christina Anderson
Individual provider Active NPI Professional Counselor · Janesville, WI
NPI 1366911489 · NPPES record last updated Nov 19, 2018
Key facts
- NPI
- 1366911489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 6671-125 (WI)
- Practice address
- 1818 Pershing PL
Janesville, WI 53546 - Phone
- (608) 312-1760
- NPI assigned
- Nov 19, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 2013
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Abg Wellness Group Inc
Practice addresses (Care Compare)
11414 W Park PL
Suite 202
Milwaukee, WI 53224-3500
Phone (414) 292-7060
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240319001240 | WI | Practitioner - Marriage and Family Therapist | 4385081900 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6671-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Life Worth Living Counseling Service LLC | Current | Accepting new patients | |
| Abg Wellness Group Inc | Current |
Accepting new patients |
Locations
11414 W Park Pl
Ste 202
Milwaukee, WI 53224
Phone (414) 292-7060
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6671-125 | WI | Yes |
Addresses
Primary practice location
1818 Pershing PL
Janesville, WI 53546
Mailing address
400 E Grand Ave Ste 208
Beloit, WI 53511-6200
Phone (608) 713-9291
Other providers in Janesville, WI
- Rebecca Amstutz
- Yone Amuka
- Dryw C Anderson
- Jane E Anderson
- Kaj U Anderson
- Michelle M Anderson
- Sarah Anderson
- Sheree R Anderson
- Sylvia Andrus
- Mark P. Angevine
All providers in Janesville, WI · Professional Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.