Provider Demographics
NPI:1619208329
Name:LASMANE, INA (LMFT)
Entity Type:Individual
Prefix:
First Name:INA
Middle Name:
Last Name:LASMANE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 THIMSEN AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-4108
Mailing Address - Country:US
Mailing Address - Phone:612-559-8704
Mailing Address - Fax:612-279-8205
Practice Address - Street 1:5100 THIMSEN AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-4108
Practice Address - Country:US
Practice Address - Phone:612-559-8704
Practice Address - Fax:612-279-8205
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1970106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1619208329Medicaid