Latanya Cork, LMSW

Individual provider Active NPI Mental Health Counselor · Jackson, MS

NPI 1417501693 · NPPES record last updated Apr 17, 2026

Key facts

NPI
1417501693
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
M11277
Practice address
3450 Highway 80 W
Jackson, MS 39209-7201
Phone
(601) 321-2400
NPI assigned
Jul 26, 2019
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X M11277 Yes

Addresses

Primary practice location

3450 Highway 80 W
Jackson, MS 39209-7201

Mailing address

3450 Highway 80 W
Jackson, MS 39209-7201
Phone (601) 738-5260

Other providers in Jackson, MS

All providers in Jackson, MS · Mental Health Counselor in Mississippi

Sources for this page

Verify at the official NPI Registry.