Healthcare Provider Details

I. General information

NPI: 1205646395
Provider Name (Legal Business Name): LATTER RAIN COUNSELING & THERAPEUTIC SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 MAIN ST NW STE 201
LENOIR NC
28645-5420
US

IV. Provider business mailing address

1524 INDIAN HILLS DR
LENOIR NC
28645-9552
US

V. Phone/Fax

Practice location:
  • Phone: 828-572-0395
  • Fax:
Mailing address:
  • Phone: 828-726-9015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. DONAIEL ANTUINETTE ALLEN
Title or Position: COUNSELOR
Credential: LCMMHC, NCC
Phone: 828-572-0395