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Individual

KERRY LASSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.C.S.W

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005707
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004247088
CT
01
140005707CT01
ANTHEM
CT
01
339452
MHN
CT
01
42-1643030
MULTIPLAN
CT
Enumeration date
04/03/2006
Last updated
11/07/2019
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