Provider Demographics
NPI:1548155195
Name:MCLEOD, LATASHIA MONET (LCSW)
Entity type:Individual
Prefix:
First Name:LATASHIA
Middle Name:MONET
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 PARK DR
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:VA
Mailing Address - Zip Code:22963-3255
Mailing Address - Country:US
Mailing Address - Phone:919-480-6899
Mailing Address - Fax:
Practice Address - Street 1:11828 FISHING POINT DR STE 102
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4500
Practice Address - Country:US
Practice Address - Phone:757-746-2332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040183671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical