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Individual
MR. MENZO LEE FAASSEN
Active
Individual
MR. MENZO LEE FAASSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701010945
VA
101YM0800X
Mental Health Counselor
3360
TN
101YM0800X
Mental Health Counselor
CCMH0201241
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701010945
LPCC
VA
01
—
3360
STATE OF TN LICENSURE
TN
01
—
CCMH0201241
STATE OF NM
NM
Enumeration date
04/29/2010
Last updated
05/02/2024
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