MEDICARE: MR. HORACE LATTIMORE JR. LPC,CAADC

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	101YM0800X	Mental Health Counselor	6401012842	MI
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	C-02510	MI

General Provider Information

NPI Number	:	1720411937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HORACE LATTIMORE JR. LPC,CAADC

Provider Business Mailing Address
First Line	:	2700 BAKER STREET, MUSKEGON HEIGHTS, MI, USA
Second Line	:
City	:	MUSKEGON HGTS.
State	:	MI
Zip	:	49444
Country	:	US
Telephone Number	:	231-737-1335
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 BAKER STREET, MUSKEGON HEIGHTS, MI, USA
Second Line	:
City	:	MUSKEGON HGTS.
State	:	MI
Zip	:	49444
Country	:	US
Telephone Number	:	231-375-9076
Fax Number	:	231-375-9076

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

Provider Enumeration Date	:	08/12/2013
Last Update Date	:	02/10/2026

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