Latasha Tameka Johnson, LPC
Individual provider Active NPI Professional Counselor · Roxie, MS
NPI 1992367940 · NPPES record last updated Jun 30, 2019
Key facts
- NPI
- 1992367940
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC007747 (GA)
- Practice address
- 9106 McNair Rd
Roxie, MS 39661-9324 - Phone
- (404) 457-7029
- NPI assigned
- Jun 30, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC007747 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Professional | Current | Accepting new patients |
Interoperability endpoints
- latashajohnson@tdh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC007747 | GA | Yes |
Addresses
Primary practice location
9106 McNair Rd
Roxie, MS 39661-9324
Mailing address
9106 McNair Rd
Roxie, MS 39661-9324
Phone (404) 457-7029
Other providers in Roxie, MS
All providers in Roxie, MS · Professional Counselor in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.