MS. QUEENIE V. LATHAN LPCC-S
NPI 1124259122
Counselor - Professional in Niles, OH

Q: What is Queenie Lathan's NPI number?

The NPI number for Queenie Lathan is 1124259122. It was assigned to this individual provider in the NPPES registry on August 7, 2009.

Q: What is Queenie Lathan's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Queenie Lathan was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 07, 2009PECOS EnrolledAccepts Medicare Assignment

165 E PARK AVE, NILES, OH 44446(330) 544-8005(330) 544-9379 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2018, Jul 6, 2017, Jun 24, 2017 and 2 more (5 updates tracked since 2016).

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About Ms. Queenie V. Lathan Lpcc-s NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. QUEENIE V. LATHAN LPCC-S (NPI 1124259122) is an individual professional provider in Niles, Ohio, licensed in Ohio (E0700418SUPV) and active in the NPI registry since August 2009. She is enrolled in Medicare PECOS, maintains a secondary practice location in Warren, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1124259122

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameMS. QUEENIE V. LATHANCredential: LPCC-S

Location Address165 E PARK AVENiles, OH 44446-2352

Mailing Address1063 Bryan Place, NwWarren, OH 44485 · (330) 219-5892

Phone(330) 544-8005

Fax(330) 544-9379

Sole ProprietorYes

Medical School CMSOtherGraduated 2009

Enumeration DateAugust 7, 2009

Last NPPES UpdateMarch 17, 20185 updates tracked since enumeration

✔ NPI 1124259122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in OH · E0700418SUPV

165 E PARK AVE, Niles, OH 44446

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Secondary Practice Location 1

Location 1108 Main Ave SW Ste 903Warren, OH 44481-1010 · Phone (330) 219-5892

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Queenie V. Lathan Lpcc-s is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820487051

PECOS Enrollment IDI20250623000122

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. THOMAS WILLIAM O'DONNELL LPC

Counselor (Professional)