Individual
DR. LATEISHA ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DBH, MS, LPC, CRC
Contact information
Practice address
509 MADISON ST SE, HUNTSVILLE, AL 35801-4206
(256) 658-9123
Mailing address
111 CHASE LAKE TRL, HUNTSVILLE, AL 35811-8139
(256) 658-9123
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
4064
AL
Other
Enumeration date
11/24/2019
Last updated
11/24/2019
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