Provider Demographics
NPI:1285213108
Name:GUYTON, LATIA (LCMHC)
Entity Type:Individual
Prefix:
First Name:LATIA
Middle Name:
Last Name:GUYTON
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 605
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28335-0605
Mailing Address - Country:US
Mailing Address - Phone:804-614-0000
Mailing Address - Fax:
Practice Address - Street 1:704 CROMWELL DR STE A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5894
Practice Address - Country:US
Practice Address - Phone:252-220-0420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15890101YM0800X
NCA15890101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health