Provider Demographics
NPI:1184066219
Name:LACASSE, JUSTIN JOHN (DO)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:JOHN
Last Name:LACASSE
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1493 CAMBRIDGE ST
Mailing Address - Street 2:CAMBRIDGE HEALTH ALLIANCE - DEPARTMENT OF PSYCHIATRY
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-1047
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:617-665-2521
Practice Address - Street 1:1493 CAMBRIDGE ST
Practice Address - Street 2:CAMBRIDGE HEALTH ALLIANCE - DEPARTMENT OF PSYCHIATRY
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1047
Practice Address - Country:US
Practice Address - Phone:617-665-2152
Practice Address - Fax:617-665-2521
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2017-05-04
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Provider Licenses
StateLicense IDTaxonomies
MA2692912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry