Provider Demographics
NPI:1083972566
Name:HARRIS-FREEMAN, LATOYA MONE (MS, CRC, LPC, LCAS)
Entity Type:Individual
Prefix:MS
First Name:LATOYA
Middle Name:MONE
Last Name:HARRIS-FREEMAN
Suffix:
Gender:F
Credentials:MS, CRC, LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4867 KIM CT
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-2659
Mailing Address - Country:US
Mailing Address - Phone:252-495-0410
Mailing Address - Fax:
Practice Address - Street 1:4867 KIM CT
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-2659
Practice Address - Country:US
Practice Address - Phone:252-495-0410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCRC #00114192101Y00000X
NC2153101YA0400X
GAC0232101YA0400X
GALPC009729101YM0800X, 101YP2500X
NC8904101YM0800X, 101YP2500X
NCA8904101YM0800X
NC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional