Provider Demographics
NPI:1760539886
Name:HAMBRIGHT, LATRICE (MA, LPC, CAADC, CCDP)
Entity Type:Individual
Prefix:MS
First Name:LATRICE
Middle Name:
Last Name:HAMBRIGHT
Suffix:
Gender:F
Credentials:MA, LPC, CAADC, CCDP
Other - Prefix:MS
Other - First Name:LATRICE
Other - Middle Name:
Other - Last Name:HAMBRIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CAADC, CCDPL
Mailing Address - Street 1:365 GREEN MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-1990
Mailing Address - Country:US
Mailing Address - Phone:215-280-3477
Mailing Address - Fax:215-814-8983
Practice Address - Street 1:261 OLD YORK RD STE 405
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3722
Practice Address - Country:US
Practice Address - Phone:215-280-3477
Practice Address - Fax:215-814-8983
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000891101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1245OtherCERTIFIED ADDICTIONS COUNSELOR
PA5631OtherCERTIFIED CO-OCCURRING DISORDERS SPECIALIST