Individual
KERRY LASSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W
Contact information
Practice address
2 TRAP FALLS RD STE 120, SHELTON, CT 06484
(203) 816-6424
Mailing address
29 MESA DR, BETHANY, CT 06524-3093
(203) 641-6090
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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