Provider Demographics
NPI:1598298630
Name:CRAIG, LATRINA (LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:LATRINA
Middle Name:
Last Name:CRAIG
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13344 BUCKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4903
Mailing Address - Country:US
Mailing Address - Phone:225-283-6338
Mailing Address - Fax:855-908-2548
Practice Address - Street 1:13344 BUCKLEY AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4903
Practice Address - Country:US
Practice Address - Phone:225-283-6338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4220101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3948770Medicaid