Provider Demographics
NPI:1750454039
Name:LASKEY, JANE A (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:A
Last Name:LASKEY
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 WOODLOT RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3452
Mailing Address - Country:US
Mailing Address - Phone:413-534-2781
Mailing Address - Fax:413-534-2659
Practice Address - Street 1:575 BEECH ST
Practice Address - Street 2:HOLYOKE MEDICAL CENTER, OUTPT. BEHAV. HEALTH
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-2223
Practice Address - Country:US
Practice Address - Phone:413-534-2781
Practice Address - Fax:413-534-2659
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1043291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000529001Medicare PIN
MAP21400Medicare ID - Type Unspecified