Provider Demographics
NPI:1285706457
Name:WINSTON, LATRICE III (LPC)
Entity type:Individual
Prefix:MS
First Name:LATRICE
Middle Name:
Last Name:WINSTON
Suffix:III
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13293
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-0293
Mailing Address - Country:US
Mailing Address - Phone:804-301-0618
Mailing Address - Fax:
Practice Address - Street 1:230 S CRATER RD
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-4424
Practice Address - Country:US
Practice Address - Phone:804-733-2180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003562101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional