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NPI Code Detail

MEDICARE: MRS. LAUREL LASSER LMSW

MEDICARE: MRS. LAUREL LASSER LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker6801095533MI

General Provider Information

NPI Number : 1447688346
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAUREL LASSER LMSW
Provider Business Mailing Address
First Line : 6549 TOWN CENTER DR STE A
Second Line :
City : CLARKSTON
State : MI
Zip : 48346-4824
Country : US
Telephone Number : 248-620-6400
Fax Number :
Provider Business Practice Location Address
First Line : 13305 REECK CT
Second Line :
City : SOUTHGATE
State : MI
Zip : 48195-3197
Country : US
Telephone Number : 734-225-2090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2013
Last Update Date : 03/17/2018

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