Healthcare Provider Details

I. General information

NPI: 1255265500
Provider Name (Legal Business Name): LATESSA LAWSON LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 MAIN ST
WILLIAMSBURG KY
40769-1123
US

IV. Provider business mailing address

323 MAIN ST
WILLIAMSBURG KY
40769-1123
US

V. Phone/Fax

Practice location:
  • Phone: 606-825-6011
  • Fax:
Mailing address:
  • Phone: 606-825-6011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number266174
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: