Provider Demographics
NPI:1811230998
Name:LASSEN, JANET MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:MARIE
Last Name:LASSEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 W BRUNDAGE ST
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-4217
Mailing Address - Country:US
Mailing Address - Phone:307-674-1668
Mailing Address - Fax:307-674-1667
Practice Address - Street 1:12451 HWY 1806 N
Practice Address - Street 2:
Practice Address - City:MOBRIDGE
Practice Address - State:SD
Practice Address - Zip Code:57601-5760
Practice Address - Country:US
Practice Address - Phone:605-845-7181
Practice Address - Fax:605-845-5072
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLCSW-8301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYLCSW-830OtherSTATE LICENSURE
MTLCSW-2342OtherMONTANA LCSW LICENSE BOARD