Mike Latella, CADC-II

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1241 Issued in GA

Practice address

111 Petrol PT Ste a-3
Peachtree City, GA 30269-1550

Phone

(678) 568-9049

NPI assigned

Aug 16, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

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": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1629624382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 PETROL PT STE A-3",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691550",
            "telephone_number": "678-568-9049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 PETROL PT STE A-3",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691550",
            "telephone_number": "678-568-9049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATELLA",
        "first_name": "MIKE",
        "name_prefix": "Mr.",
        "credential": "CADC-II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-16",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "1241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA CERTIFIED DRUG AND ALCOHOL EVALUATOR NUMBER",
            "identifier": "3918",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED TELE-MEDICAL ELECTRONIC DRUG AND ALCOHOL COUNSELOR",
            "identifier": "EO56",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA CERTIFIED ALCOHOL AND DRUG COUNSELOR LEVEL II NUMBER",
            "identifier": "1241",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNATIONALLY CERTIFIED ALCOHOL AND DRUG COUNSELOR",
            "identifier": "809429",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Stanley Lane, M.DIV. AND D.MIN.
• William David Lane, PH.D.
• Rebecca Block Lapidus, PH.D.
• Jacob Alexander Larison, FNP-C
• Robin Elizabeth Lasseter, NCC, LAPC
• Losheilah Lawrence, PT
• Ann Saracini Layman, O.D.
• Phuong Binh Le, MD
• Emily Anne Ledbetter
• Abigail Hope Leedy

• Addiction (Substance Use Disorder) Counselor in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Addiction (Substance Use Disorder) Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.