Healthcare Provider Details

I. General information

NPI: 1326560798
Provider Name (Legal Business Name): LATOYA CHERMESE SUTTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 MERIDIAN PKWY STE 300 #26668
DURHAM NC
27713
US

IV. Provider business mailing address

2530 MERIDIAN PKWY STE 300
DURHAM NC
27713-5273
US

V. Phone/Fax

Practice location:
  • Phone: 919-909-8805
  • Fax:
Mailing address:
  • Phone: 919-410-5115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCO15570
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17003
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904015011
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number23569
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: