Individual
JAN LASSETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1612 RAILROAD AVENUE, GUNTERSVILLE, AL 35976-1111
(256) 582-8880
(256) 582-8890
Mailing address
PO BOX 1001, GUNTERSVILLE, AL 35976-7001
(256) 582-8880
(256) 582-8890
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
1615
AL
101YM0800X
Mental Health Counselor
Primary
LPC-1615
AL
101YP2500X
Professional Counselor
LPC-1615
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51520298LAS
BCBS OF ALABAMA
AL
01
—
51522539LAS
FEDERAL BCBS
AL
Enumeration date
01/17/2007
Last updated
09/07/2023
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