Provider Demographics
NPI:1659603959
Name:LASITER, MARY CATHERINE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:CATHERINE
Last Name:LASITER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:CATHERINE
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:3683 S FIRST ST
Mailing Address - Street 2:
Mailing Address - City:JENA
Mailing Address - State:LA
Mailing Address - Zip Code:71342-6409
Mailing Address - Country:US
Mailing Address - Phone:318-992-2263
Mailing Address - Fax:
Practice Address - Street 1:3683 S FIRST ST
Practice Address - Street 2:
Practice Address - City:JENA
Practice Address - State:LA
Practice Address - Zip Code:71342-6409
Practice Address - Country:US
Practice Address - Phone:318-992-2263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2022-08-10
Deactivation Date:2019-09-05
Deactivation Code:
Reactivation Date:2020-12-09
Provider Licenses
StateLicense IDTaxonomies
LA10662171M00000X
225500000X
LA10062104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist