Lake Norman Psychiatry & Counseling, PLLC

Primary specialty

Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X

License

35688 Issued in NC

Legal business name

LAKE NORMAN PSYCHIATRY & COUNSELING, PLLC

Practice address

116 South Main Street Suite 205
Mooresville, NC 28115-0900

Phone

(704) 662-3270

Fax

(704) 662-3288

NPI assigned

May 3, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Edward Latz Jr., M.D.NPI 1013972025

Title

Member Manager

Phone

(704) 662-3200

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Edward Latz Jr., M.D.

  • Psychiatry Physician
  • Catawba, NC
  • NPI 1013972025
  NPD (past) Authorized official
• Tracy Thompson Latz, M.D., M.S.

  • Psychiatry Physician
  • Mooresville, NC
  • NPI 1407879851
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568674752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 SOUTH MAIN STREET SUITE 205",
            "address_2": "PO BOX 900",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281150900",
            "telephone_number": "704-662-3270",
            "fax_number": "704-662-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 SOUTH MAIN STREET SUITE 205",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281150900",
            "telephone_number": "704-662-3270",
            "fax_number": "704-662-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE NORMAN PSYCHIATRY & COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LATZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "704-662-3200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "NC",
            "license": "35688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890276R",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "0276R",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Norman OBGYN LLP
• Lake Norman Ophthalmology PLLC
• Lake Norman Pain and Weight Management, LLC
• Lake Norman Pediatrics, PA
• Lake Norman Plastic Surgery
• Lake Norman Pulmonary & Sleep, PA
• Lake Norman Regional Medical Center-Home Health (Lake Norman Home Health)
• Lake Norman Sleep Center, PA
• Lake Norman Surgical Assisting
• Lake Norman Surgical Associates

• Psychosomatic Medicine Physician in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Psychosomatic Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.