Provider Demographics
NPI:1699190363
Name:LATTIMORE, TRINITA RENEE (LCPC-S)
Entity type:Individual
Prefix:
First Name:TRINITA
Middle Name:RENEE
Last Name:LATTIMORE
Suffix:
Gender:F
Credentials:LCPC-S
Other - Prefix:
Other - First Name:TRINITA
Other - Middle Name:RENEE
Other - Last Name:LATTIMORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC-S
Mailing Address - Street 1:12138 CENTRAL AVE APT 575
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1910
Mailing Address - Country:US
Mailing Address - Phone:301-648-2335
Mailing Address - Fax:
Practice Address - Street 1:9135 PISCATAWAY RD., 3RD FL., STE 340
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2549
Practice Address - Country:US
Practice Address - Phone:301-648-2335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MDLC8509101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health