Provider Demographics
NPI:1629797261
Name:BARBER, LATASHA NICOLE (MFT, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:LATASHA
Middle Name:NICOLE
Last Name:BARBER
Suffix:
Gender:F
Credentials:MFT, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11304 FLORA SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-2409
Mailing Address - Country:US
Mailing Address - Phone:813-699-0074
Mailing Address - Fax:
Practice Address - Street 1:6605 TRENT CREEK DR
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-0124
Practice Address - Country:US
Practice Address - Phone:813-922-6804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X, 101YM0800X
MO2021011025101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health