Provider Demographics
NPI:1891168712
Name:WEBB, LATORRIS (LPC)
Entity Type:Individual
Prefix:
First Name:LATORRIS
Middle Name:
Last Name:WEBB
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:653 PICKWICK PL
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71108-5743
Mailing Address - Country:US
Mailing Address - Phone:318-734-0375
Mailing Address - Fax:318-871-1076
Practice Address - Street 1:9051 MANSFIELD RD RM 7
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-2674
Practice Address - Country:US
Practice Address - Phone:318-553-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-02
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5419101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional