Provider Demographics
NPI:1578738175
Name:LASSMAN, JESSICA RICH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:RICH
Last Name:LASSMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ADDEE CIR
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-1006
Mailing Address - Country:US
Mailing Address - Phone:917-734-7179
Mailing Address - Fax:212-656-1286
Practice Address - Street 1:14 RYE RIDGE PLZ
Practice Address - Street 2:SUITE 236
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-2826
Practice Address - Country:US
Practice Address - Phone:917-734-7179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015024103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent