Provider Demographics
NPI:1376871681
Name:LATHAM, ERNEST HARGREAVES (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:HARGREAVES
Last Name:LATHAM
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 602
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1722
Mailing Address - Country:US
Mailing Address - Phone:202-285-4606
Mailing Address - Fax:
Practice Address - Street 1:1350 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 602
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1722
Practice Address - Country:US
Practice Address - Phone:202-285-4606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000557103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical