Provider Demographics
NPI:1871277178
Name:CUE, LATASHA NICOLE (CSAC-S, MS)
Entity type:Individual
Prefix:MRS
First Name:LATASHA
Middle Name:NICOLE
Last Name:CUE
Suffix:
Gender:F
Credentials:CSAC-S, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 WRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-3250
Mailing Address - Country:US
Mailing Address - Phone:757-749-2577
Mailing Address - Fax:
Practice Address - Street 1:166 WRIGHT AVE
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-3250
Practice Address - Country:US
Practice Address - Phone:804-234-4533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0709025933101YA0400X
VA175T00000X, 106S00000X, 175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician