Provider Demographics
NPI:1184132409
Name:LASSITER, LATASHA LASHAWN (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:LATASHA
Middle Name:LASHAWN
Last Name:LASSITER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 NOLAN TRCE STE B
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-3838
Mailing Address - Country:US
Mailing Address - Phone:337-404-7731
Mailing Address - Fax:
Practice Address - Street 1:1112 NOLAN TRCE STE B
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-3838
Practice Address - Country:US
Practice Address - Phone:337-404-7731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 101Y00000X
LA171M00000X
LA7649101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor