Provider Demographics
NPI:1023210606
Name:LASETER, ELLEN LUFFMAN (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:LUFFMAN
Last Name:LASETER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:VA
Mailing Address - Zip Code:23847-2821
Mailing Address - Country:US
Mailing Address - Phone:434-348-0698
Mailing Address - Fax:
Practice Address - Street 1:1625 WALNUT DR
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-2821
Practice Address - Country:US
Practice Address - Phone:434-348-0698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040035141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical