Shane Gregory Latham

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6552 Issued in WI

Practice address

100 Century Park S Ste 102
Birmingham, AL 35226-3922

Phone

(888) 386-9624

NPI assigned

Sep 18, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Sound Mind Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pelham, AL
  • NPI 1770291858
  NPD Authorized official

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1497274781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 ARABIAN RD",
            "city": "COLUMBIANA",
            "state": "AL",
            "postal_code": "350513262",
            "telephone_number": "815-353-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CENTURY PARK S STE 102",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352263922",
            "telephone_number": "888-386-9624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8500 W North Ave",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532262844",
            "country_code": "US",
            "telephone_number": "414-252-5166",
            "fax_number": "414-755-1352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "SHANE",
        "middle_name": "GREGORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-18",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Lassiter
• Cynthia Lassiter, MD
• Jerrod Latham
• Jessi Michaela Latham
• Piper Elizabeth Latham, PA
• Anne Sherman Lathan, RD, LD
• Zoya Latif
• Wesley Latimer, D.D.S.
• Johan Latorre, M.D., M.S
• Clifton A Latting, M.D.

• Professional Counselor in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Professional Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.