Provider Demographics
NPI:1114340684
Name:LASSAR, MARGOT (LCSW)
Entity Type:Individual
Prefix:
First Name:MARGOT
Middle Name:
Last Name:LASSAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 E OHIO ST
Mailing Address - Street 2:UNIT 1004
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5452
Mailing Address - Country:US
Mailing Address - Phone:216-849-6701
Mailing Address - Fax:
Practice Address - Street 1:355 E OHIO ST
Practice Address - Street 2:UNIT 1004
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5452
Practice Address - Country:US
Practice Address - Phone:216-849-6701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490161411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical