MEDICARE: MRS. HEIDI MARIE LASSER LCPC

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
1	101YP2500X	Professional Counselor	6401005493	MI
2	101YM0800X	Mental Health Counselor	LPC-16754	AZ

General Provider Information

NPI Number	:	1982884110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEIDI MARIE LASSER LCPC

Provider Business Mailing Address
First Line	:	1910 N LAKES PL
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83646-5939
Country	:	US
Telephone Number	:	208-342-2273
Fax Number	:	208-893-5484

Provider Business Practice Location Address
First Line	:	1910 N LAKES PL
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83646-5939
Country	:	US
Telephone Number	:	208-342-2273
Fax Number	:	208-893-5484

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2007
Last Update Date	:	01/09/2024

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