Provider Demographics
NPI:1891882429
Name:NASSEN, LANA M (LPC)
Entity Type:Individual
Prefix:DR
First Name:LANA
Middle Name:M
Last Name:NASSEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6980 N PORT WASHINGTON RD
Mailing Address - Street 2:202
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-3900
Mailing Address - Country:US
Mailing Address - Phone:414-351-7100
Mailing Address - Fax:414-247-4082
Practice Address - Street 1:6980 N PORT WASHINGTON RD
Practice Address - Street 2:202
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53217-3900
Practice Address - Country:US
Practice Address - Phone:414-351-7100
Practice Address - Fax:414-247-4082
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3036101YM0800X
WI4165-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO3036OtherLPC
WI4165-125OtherLPC