Provider Demographics
NPI:1942098900
Name:LATEEF, HUSAIN (PHD, MSW)
Entity type:Individual
Prefix:DR
First Name:HUSAIN
Middle Name:
Last Name:LATEEF
Suffix:
Gender:M
Credentials:PHD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 SHERWICK TER
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63021-6745
Mailing Address - Country:US
Mailing Address - Phone:602-516-2277
Mailing Address - Fax:
Practice Address - Street 1:745 SHERWICK TER
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63021-6745
Practice Address - Country:US
Practice Address - Phone:602-516-2277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150113856104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker