Provider Demographics
NPI:1851352496
Name:LASSITER, JAMES F (PHD, ABPP)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:F
Last Name:LASSITER
Suffix:
Gender:M
Credentials:PHD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 OLD GREENBRIER ROAD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2648
Mailing Address - Country:US
Mailing Address - Phone:757-228-5635
Mailing Address - Fax:757-233-0327
Practice Address - Street 1:2006 OLD GREENBRIER ROAD
Practice Address - Street 2:SUITE 12
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2648
Practice Address - Country:US
Practice Address - Phone:757-228-5635
Practice Address - Fax:757-233-0327
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003492103TC0700X, 103TC0700X, 103TC2200X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010246601Medicaid
VA010246601Medicaid
VAR52966Medicare UPIN