Provider Demographics
NPI:1376278051
Name:ADGERSON, LATASHA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LATASHA
Middle Name:
Last Name:ADGERSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LATASHA
Other - Middle Name:
Other - Last Name:ADGERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1111 HOKE LN
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-2637
Mailing Address - Country:US
Mailing Address - Phone:703-209-2081
Mailing Address - Fax:
Practice Address - Street 1:355 CRAWFORD ST STE 333
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-2819
Practice Address - Country:US
Practice Address - Phone:757-383-9215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013337101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional