Individual ProviderLatanyle Kennedy-SmithCounselorBehavioral Health & Social Service ProvidersPractice Address1644 Carter St # B, Suite 2, Vidalia, LA 71373-3143(318) 414-3065PECOS EnrollmentBased on the most recent information from CMS, provider Latanyle Kennedy-Smith does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:54 AM.Profile DetailsProvider ID1952768707Provider TypeIndividualFull NameKennedy-Smith, LatanyleCredentialMSGenderFemaleSole ProprietorYesEnumeration Date1/25/2016Last Updated1/25/2016Contact InformationPractice LocationPractice Address1644 Carter St # B, Suite 2, Vidalia, LA 71373-3143Phone(318) 414-3065Fax(318) 414-3067Mailing LocationMailing Address1644 Carter St # B, Suite 2, Vidalia, LA 71373-3143Phone(318) 414-3065Fax(318) 414-3067Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer