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Contact Information

EDWARD E LATHAM JR, PhD
404 E MARKET ST
KINGSPORT, TN37660-4828
 Phone: 423-392-6898
 Fax: 423-392-6900
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Addiction (Substance Use Disorder)

103TA0400X 62 Psychologist, Clinical
 

Adult Development & Aging

103TA0700X 62 Psychologist, Clinical
 

Group Psychotherapy

103TP2701X 62 Psychologist, Clinical
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for EDWARD E LATHAM JR · (Male)

NPI # 1851439988
Status Active
Credentials PhD
Entity Individual
Enumeration date 02/01/2007
Last updated 01/24/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • TN License # P1405
  • TN Other 4418397 AETNA
  • TN Other 063454 BCBS VA
  • TN Other 0099539 BCBSTN
  • TN Other 4067035 BCBSTN-MEDICAL
  • TN Other 241583000 MAGELLAN
  • TN Other 9213176 PHCS
  • TN Other 1437005 UMWA
  • TN Other 6109533 UNITED HEALTHCARE
  • TN Other 132696 VALUE OPTIONS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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