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General NPI Number Information
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NPI Number | 1790295343
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Entity Type | Individual
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Provider Name | SHANA ULON LATHAM LPC PRC13693
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Gender | Female
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Dates
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Enumeration Date | 10/10/2017
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Last Update Date | 10/10/2017
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Provider Practice Location Address
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Address Line | 1301 LENFANT SQ SE
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City | WASHINGTON
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State | DC
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Zip | 20020-6724
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Country | US
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Telephone | 202-584-1244
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Fax | 202-584-1249
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Provider Business Mailing Address
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Address Line | 3321 7TH ST SE
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City | WASHINGTON
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State | DC
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Zip | 20032-4212
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Country | US
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Telephone | 202-373-1302
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | PRC13693
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | PRC13693
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PRC13693
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License Number State | DC
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