MEDICARE: LATESHA LAFAYETTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6851120876	MI

General Provider Information

NPI Number	:	1427929439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATESHA LAFAYETTE

Provider Business Mailing Address
First Line	:	411 W LAKE LANSING RD STE B110
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-8468
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 W LAKE LANSING RD STE B110
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-8468
Country	:	US
Telephone Number	:	517-657-3533
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	09/15/2025

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Directions to “ LATESHA LAFAYETTE ” Practice Location

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