Individual provider · Type 1 NPI

Latonya Lidge

Addiction (Substance Use Disorder) Counselor · Jamaica, NY

NPI number 1629795315 Active

Practice location

9002 161st St
Jamaica, NY 11432-6108

Call (718) 520-1513 Map

Fax (718) 520-6460

Mailing address

3412 113th St # 2
Corona, NY 11368-1425

Other practice locations

  • 8002 Kew Gardens Rd, Kew Gardens, NY 11415-3600 · (718) 520-1513

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X33326-T (NY)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1629795315

Latonya Lidge's National Provider Identifier is 1629795315, issued on Oct 24, 2022. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Jamaica, NY. The record was last updated on Nov 29, 2022.