MR. MIKE LATELLA CADC-II NPI 1629624382

NPI Information

NPI: 1629624382
Provider Name: MR. MIKE LATELLA, CADC-II
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
111 PETROL PT STE A-3
PEACHTREE CITY, GA
ZIP 30269
Phone: (678) 568-9049
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MR. Mike Latella, CADC-II is an addiction (substance use disorder) counselor in Peachtree City, GA. MR. Mike Latella, CADC-II NPI is 1629624382. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

111 PETROL PT STE A-3
PEACHTREE CITY, GA
ZIP 30269-550
Phone: (678) 568-9049

The enumeration date for this NPI number is 8/16/2019 and was last updated on 8/16/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	1241	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	EO56	OTHER	GEORGIA	CERTIFIED TELE-MEDICAL ELECTRONIC DRUG AND ALCOHOL COUNSELOR
2	1241	OTHER	GEORGIA	GA CERTIFIED ALCOHOL AND DRUG COUNSELOR LEVEL II NUMBER
3	3918	OTHER	GEORGIA	GA CERTIFIED DRUG AND ALCOHOL EVALUATOR NUMBER
4	809429	OTHER	GEORGIA	INTERNATIONALLY CERTIFIED ALCOHOL AND DRUG COUNSELOR

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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