Provider Demographics
NPI:1053857086
Name:WEBB, LATOYIA C (MS, LPC, SAC-IT)
Entity type:Individual
Prefix:MS
First Name:LATOYIA
Middle Name:C
Last Name:WEBB
Suffix:
Gender:F
Credentials:MS, LPC, SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4130 W MARTIN DR APT 103
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-2750
Mailing Address - Country:US
Mailing Address - Phone:414-702-7373
Mailing Address - Fax:
Practice Address - Street 1:4130 W MARTIN DR APT 103
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-2750
Practice Address - Country:US
Practice Address - Phone:414-702-7373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-14
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18160-130101YA0400X
FLTPMC4485101YM0800X
WI8252-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1053857086Medicaid
FL1053857086Medicaid