Healthcare Provider Details

I. General information

NPI: 1720908874
Provider Name (Legal Business Name): JOSEPH LATASSA CASAC-T
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 PAGE PARK DR
POUGHKEEPSIE NY
12603-7500
US

IV. Provider business mailing address

41 PAGE PARK DR
POUGHKEEPSIE NY
12603-7500
US

V. Phone/Fax

Practice location:
  • Phone: 845-486-2950
  • Fax:
Mailing address:
  • Phone: 845-486-2950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number42528
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: