Provider Demographics
NPI:1043032246
Name:BURROWS, LATEYA RAYSHAWN (LCADC)
Entity type:Individual
Prefix:MS
First Name:LATEYA
Middle Name:RAYSHAWN
Last Name:BURROWS
Suffix:
Gender:F
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5614 FRANKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-6116
Mailing Address - Country:US
Mailing Address - Phone:443-760-7330
Mailing Address - Fax:
Practice Address - Street 1:6207 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-1942
Practice Address - Country:US
Practice Address - Phone:443-835-2681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA3398101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)