Provider Demographics
NPI:1346930286
Name:COLEY, LATASHA (M ED, LMSW)
Entity Type:Individual
Prefix:
First Name:LATASHA
Middle Name:
Last Name:COLEY
Suffix:
Gender:F
Credentials:M ED, LMSW
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 704
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:DE
Mailing Address - Zip Code:19938-0704
Mailing Address - Country:US
Mailing Address - Phone:215-554-9470
Mailing Address - Fax:
Practice Address - Street 1:187 SPELT DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:DE
Practice Address - Zip Code:19938-7780
Practice Address - Country:US
Practice Address - Phone:215-554-9470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health