Provider Demographics
NPI:1477980589
Name:HENEGAR, LATRICA YVONNE (LPC-S, NCC, ACGC-III)
Entity Type:Individual
Prefix:DR
First Name:LATRICA
Middle Name:YVONNE
Last Name:HENEGAR
Suffix:
Gender:F
Credentials:LPC-S, NCC, ACGC-III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 EXECUTIVE PARK DR STE 205
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-6199
Mailing Address - Country:US
Mailing Address - Phone:334-275-9579
Mailing Address - Fax:334-275-9581
Practice Address - Street 1:2101 EXECUTIVE PARK DR STE 205
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-6199
Practice Address - Country:US
Practice Address - Phone:334-275-9579
Practice Address - Fax:334-275-9581
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2372101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional