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General NPI Number Information
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NPI Number | 1609749233
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Entity Type | Organization
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Legal Business Name | LATITUDE COUNSELING
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 8431 S 106TH ST
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City | LA VISTA
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State | NE
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Zip | 68128-3244
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Country | US
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Telephone | 402-212-4894
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Fax | 402-330-8815
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Provider Business Mailing Address
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Address Line | 8431 S 106TH ST
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City | LA VISTA
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State | NE
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Zip | 68128-3244
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Country | US
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Telephone | 402-212-4894
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Fax | 402-330-8815
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Authorized Official
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Title or Position | OWNER
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Name | MR. TARA A VAUGHN
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Credential | PLMHP
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Telephone | 402-212-4894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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