Individual
LATASHA SHAWNTAY MCILWAINE
Active
Individual
LATASHA SHAWNTAY MCILWAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, MHA, LPC, LCAS
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
1296
NC
101YP2500X
Professional Counselor
Primary
6691
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103719
—
NC
Enumeration date
04/25/2007
Last updated
03/28/2009
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