MEDICARE: LATASHA NICOLE BARBER MFT, LPC, NCC

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
1	106H00000X	Marriage & Family Therapist
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor	2021011025	MO

General Provider Information

NPI Number	:	1629797261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATASHA NICOLE BARBER MFT, LPC, NCC

Provider Business Mailing Address
First Line	:	11304 FLORA SPRINGS DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33579-2409
Country	:	US
Telephone Number	:	813-699-0074
Fax Number	:

Provider Business Practice Location Address
First Line	:	6605 TRENT CREEK DR
Second Line	:
City	:	SUN CITY CENTER
State	:	FL
Zip	:	33573-0124
Country	:	US
Telephone Number	:	813-922-6804
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2022
Last Update Date	:	03/07/2024

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