Provider Demographics
NPI:1497005326
Name:PUGH, LATOYIA R (LCAS-A, LPC)
Entity Type:Individual
Prefix:MS
First Name:LATOYIA
Middle Name:R
Last Name:PUGH
Suffix:
Gender:F
Credentials:LCAS-A, LPC
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 843
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983-7473
Mailing Address - Country:US
Mailing Address - Phone:252-209-7200
Mailing Address - Fax:
Practice Address - Street 1:101 MAIN ST W
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-3301
Practice Address - Country:US
Practice Address - Phone:252-332-2297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)