Provider Demographics
NPI:1437499167
Name:LASSER, JESSICA LAUREN (LMSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LAUREN
Last Name:LASSER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 W 68TH ST
Mailing Address - Street 2:APARTMENT 814
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5808
Mailing Address - Country:US
Mailing Address - Phone:917-658-6899
Mailing Address - Fax:
Practice Address - Street 1:155 W 68TH ST
Practice Address - Street 2:APARTMENT 814
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5808
Practice Address - Country:US
Practice Address - Phone:917-658-6899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-16
Last Update Date:2013-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080562-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker