Provider Demographics
NPI:1992313944
Name:SUTTON, LATARA L (MSW)
Entity type:Individual
Prefix:MS
First Name:LATARA
Middle Name:L
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 E 92ND ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-3839
Mailing Address - Country:US
Mailing Address - Phone:773-822-8024
Mailing Address - Fax:
Practice Address - Street 1:140 N ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-1802
Practice Address - Country:US
Practice Address - Phone:312-850-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker