Individual provider Active NPI

Latrice Shonta Dailey, MS, LPC

  • Professional Counselor
  • Birmingham, AL
National Provider Identifier
1770058737
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC03928 Issued in AL
Practice address
2214 3Rd Ave N
Birmingham, AL 35203-3822
Phone
(205) 612-7091
NPI assigned
Oct 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC03928 AL Primary

Addresses

Primary practice location

2214 3Rd Ave N
Birmingham, AL 35203-3822

Mailing address

2214 3Rd Ave N
Birmingham, AL 35203-3822

Other practice location 1

3918 Montclair Rd Ste 206
Mountain Brk, AL 35213-2418
Phone (205) 994-2798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240328002607 AL Practitioner - Mental Health Counselor 6204273089 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LPC03928ALMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
K & F Investments LLC CurrentSince Jan 30, 2024 Accepting new patients

Locations

3918 Montclair Rd
Ste 206
Mountain Brk, AL 35213
Phone (205) 994-2798

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1770058737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 3RD AVE N",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352033822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 3RD AVE N",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352033822",
            "telephone_number": "205-612-7091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3918 Montclair Rd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Mountain Brk",
            "state": "AL",
            "postal_code": "352132418",
            "country_code": "US",
            "telephone_number": "205-994-2798",
            "fax_number": "205-778-5304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAILEY",
        "first_name": "LATRICE",
        "middle_name": "SHONTA",
        "name_prefix": "Ms.",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-05",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "LPC03928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.