Provider Demographics
NPI:1144422478
Name:HUNT, LATAYA LOCK (LBSW)
Entity Type:Individual
Prefix:MRS
First Name:LATAYA
Middle Name:LOCK
Last Name:HUNT
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5502 APACHE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305-1339
Mailing Address - Country:US
Mailing Address - Phone:601-485-7290
Mailing Address - Fax:
Practice Address - Street 1:805 S WHEATLEY ST
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-5000
Practice Address - Country:US
Practice Address - Phone:601-572-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSW5953101Y00000X
AL4312B101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor