Provider Demographics
NPI:1346030152
Name:PIKE, LATESHA L (LPC)
Entity type:Individual
Prefix:
First Name:LATESHA
Middle Name:L
Last Name:PIKE
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1741 N NEVA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60707-4316
Mailing Address - Country:US
Mailing Address - Phone:773-681-2531
Mailing Address - Fax:
Practice Address - Street 1:2298 COUNTY LINE RD UNIT 130
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-2561
Practice Address - Country:US
Practice Address - Phone:847-458-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.021419101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health