Healthcare Provider Details

I. General information

NPI: 1316873342
Provider Name (Legal Business Name): JOSEPH J LASTRAGLIO JR. LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

978 VINERIDGE RUN APT 207
ALTAMONTE SPRINGS FL
32714-1770
US

IV. Provider business mailing address

978 VINERIDGE RUN APT 207
ALTAMONTE SPRINGS FL
32714-1770
US

V. Phone/Fax

Practice location:
  • Phone: 860-884-8356
  • Fax:
Mailing address:
  • Phone: 860-884-8356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH28099
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: