Individual provider · Type 1 NPI

Latasha Shawntay McIlwaine, MA, MHA, LPC, LCAS

Professional Counselor · Charlotte, NC

NPI number 1063631331 Active

Practice location

1409 East Blvd, Suite 6B
Charlotte, NC 28203-5817

Call (704) 340-4666 Map

Fax (704) 969-7298

Mailing address

PO Box 743
Paw Creek, NC 28130-0743

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XNone listed
Professional Counselor Primary 101YP2500X6691 (NC)
Addiction (Substance Use Disorder) Counselor 101YA0400X1296 (NC)

Professional Counselor: Definition to come...

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About NPI 1063631331

Latasha Shawntay McIlwaine, MA, MHA, LPC, LCAS's National Provider Identifier is 1063631331, issued on Apr 25, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Charlotte, NC. The record was last updated on Mar 28, 2009.