Mr Nathan Latta, CPRC is a 
Peer Specialist based in Detroit, Michigan. Mr Nathan Latta is licensed to practice in Michigan (license number ) and his current practice location is 
2081 W Grand Blvd, Detroit, Michigan. He can be reached at his office (for appointments etc.) via phone at 
(313) 895-0500.
NPI number for Mr Nathan Latta is 1033776745 and his current mailing address is 707 W Milwaukee St, Detroit, Michigan. He 
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1033776745.
			
			
			
		 
		
		 
Healthcare Provider's Profile
		
			
			
			| Full Name | Mr Nathan Latta | 
|---|
| Gender | Male | 
|---|
| Speciality | Peer Specialist | 
|---|
| Location | 2081 W Grand Blvd, Detroit, Michigan | 
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. | 
			
			 
			
						  NPI Data:
			
			- NPI Number: 1033776745
 - Provider Enumeration Date: 05/29/2019
 - Last Update Date: 06/15/2023
 			
			
			 
		 
		 
Medical Identifiers
		Medical identifiers for Mr Nathan Latta such as npi, medicare ID, medicare PIN, medicaid, etc.
		
		| Identifier | Type | State | Issuer | 
		| 1033776745 | NPI | - | NPPES | 
		
		 
Medical Taxonomies and Licenses
		
		| Taxonomy | Type | License (State) | Status | 
		| 101YA0400X | Counselor - Addiction (substance Use Disorder)  | M-00262 (Michigan) | Secondary | 
| 175T00000X | Peer Specialist  |  (Michigan) | Primary | 
		
		
			
			
			
		
		
		 
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Nathan Latta is 
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
		
		
 
Mailing Address and Practice Location
		
		| Mailing Address | Practice Location Address | 
		Mr Nathan Latta, CPRC 707 W Milwaukee St, Detroit, MI 48202-2943 Ph: (313) 344-9099 | Mr Nathan Latta, CPRC 2081 W Grand Blvd, Detroit, MI 48208-1105 Ph: (313) 895-0500 | 
		
		 
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