Provider Demographics
NPI:1922144658
Name:LASTOFF, DEBRA LEE (MED LMFT)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:LEE
Last Name:LASTOFF
Suffix:
Gender:F
Credentials:MED LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:ELIOT
Mailing Address - State:ME
Mailing Address - Zip Code:03903
Mailing Address - Country:US
Mailing Address - Phone:207-752-0121
Mailing Address - Fax:
Practice Address - Street 1:6 PONDVIEW PLACE
Practice Address - Street 2:
Practice Address - City:TYNGSBORO
Practice Address - State:MA
Practice Address - Zip Code:01879
Practice Address - Country:US
Practice Address - Phone:978-649-9980
Practice Address - Fax:978-649-9127
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA614101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist