Provider Demographics
NPI:1811389455
Name:PRESCOTT-CARR, LATOSHA (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:LATOSHA
Middle Name:
Last Name:PRESCOTT-CARR
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 PARKER RD SE BLDG C
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-6654
Mailing Address - Country:US
Mailing Address - Phone:770-853-1352
Mailing Address - Fax:
Practice Address - Street 1:1775 PARKER RD SE BLDG C
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-6654
Practice Address - Country:US
Practice Address - Phone:770-728-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC00358101YM0800X
GALPC009847101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health