Individual provider · NPI-1

Latasha Renea Green, LCAS LPC CCS

Counselor, Mental Health · Windsor, NC

NPI number1023283074

StatusActive

Last updated in NPPESSep 9, 2021

Details

NPI: 1023283074
Entity type: Individual (NPI-1)
Name: Latasha Renea Green
Credential: LCAS LPC CCS
Sex: Female
Sole proprietor: No
Enumeration date: Apr 29, 2008
Certification date: Sep 9, 2021
Last updated: Sep 9, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
101YM0800X	Counselor, Mental Health	7704	NC	Yes
101YA0400X	Counselor, Addiction (Substance Use Disorder)	–	–

Practice location

312 Sterlingworth St
Windsor, NC 27983-1724

Phone 252-794-3834 · Fax 252-794-3204

Mailing address

Po Box 7281
Greenville, NC 27835-7281

Phone 252-367-7478 · Fax 252-751-0661

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