Individual
JASON W LATVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, CSAC, ICS
Contact information
Practice address
630 CHERRY ST, GREEN BAY, WI 54301-4931
(920) 435-2093
Mailing address
630 CHERRY ST, GREEN BAY, WI 54301-4931
(920) 435-2093
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15923-131
WI
101YP2500X
Professional Counselor
7386-125
WI
Other
Enumeration date
04/08/2013
Last updated
05/30/2025
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