Provider Demographics
NPI:1356752414
Name:LATITUDE COUNSELING, PLLC
Entity type:Organization
Organization Name:LATITUDE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:ECHEVARRIA GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-466-5478
Mailing Address - Street 1:10777 RICHMOND AVE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-4914
Mailing Address - Country:US
Mailing Address - Phone:787-466-5478
Mailing Address - Fax:
Practice Address - Street 1:10200 RICHMOND AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-4140
Practice Address - Country:US
Practice Address - Phone:787-466-5478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67956101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty