Provider Demographics
NPI:1750265401
Name:PINNOCK, LATIFA J (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LATIFA
Middle Name:J
Last Name:PINNOCK
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 1:53 OAK FARM CT
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-5705
Mailing Address - Country:US
Mailing Address - Phone:267-250-8991
Mailing Address - Fax:
Practice Address - Street 1:53 OAK FARM CT
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-5705
Practice Address - Country:US
Practice Address - Phone:267-250-8991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0079001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical