Individual
SUE ANNE LASSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223
(270) 461-2859
Mailing address
1940 WHIRLAWAY CIR, CLARKSVILLE, TN 37042-1503
(931) 614-8245
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CSW004573
GA
101YM0800X
Mental Health Counselor
CSW004573
GA
1041C0700X
Clinical Social Worker
6762
TN
1041C0700X
Clinical Social Worker
Primary
CSW004573
GA
Other
Enumeration date
05/15/2007
Last updated
01/09/2019
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