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NPI Code Detail

MEDICARE: CARRIE COOK LATT LISW-S

MEDICARE: CARRIE COOK LATT LISW-S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI.1501349-SUPVOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003002684
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE COOK LATT LISW-S
Provider Business Mailing Address
First Line : PO BOX 933421
Second Line :
City : CLEVELAND
State : OH
Zip : 44193-0039
Country : US
Telephone Number : 937-641-5072
Fax Number : 937-641-6129
Provider Business Practice Location Address
First Line : 3300 W TECH BLVD
Second Line :
City : MIAMISBURG
State : OH
Zip : 45342-4865
Country : US
Telephone Number : 937-641-3401
Fax Number : 937-641-3046
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2007
Last Update Date : 11/20/2025

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Directions to “ CARRIE COOK LATT LISW-S” Practice Location

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