Latisha Taylor Ellis, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC010353 Issued in GA

Practice address

106 Colony Park Drive
Suite 500
Lawrenceville, GA 30043

Phone

(770) 294-4006

NPI assigned

Jul 8, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Latisha Ericka Taylor Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1487060604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1785 ABINGER LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300433036",
            "telephone_number": "770-294-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 COLONY PARK DRIVE",
            "address_2": "SUITE 500",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30043",
            "telephone_number": "770-294-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "LATISHA",
        "middle_name": "TAYLOR",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC010353",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC010353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATISHA",
            "last_name": "TAYLOR",
            "middle_name": "ERICKA",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard S Ellin, MD
• Beverley Elliott, RN
• Cynthia Lawrence Elliott, M.D.
• Susan Kay Elliott
• Howard Ross Ellis, MD
• Robert E Ellis, DDS
• Rodica Simina Ellis, MD
• Terri M. Ellis, MS CCC-SLP
• Parker Ellison, BCBA
• Tamicia Destiny Ellison

• Professional Counselor in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.