Provider Demographics
NPI:1679385892
Name:LATTA, JAMES COREY (P-LPC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:COREY
Last Name:LATTA
Suffix:
Gender:M
Credentials:P-LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3566 CRESTWYN DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-8525
Mailing Address - Country:US
Mailing Address - Phone:901-371-7076
Mailing Address - Fax:
Practice Address - Street 1:199 SUMMITT ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-4238
Practice Address - Country:US
Practice Address - Phone:901-248-0595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP-0711101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor