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NPI Code Detail

MEDICARE: ANAMARIE LASSELLE LCPC, LADC, CCS

MEDICARE: ANAMARIE LASSELLE LCPC, LADC, CCS
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
1101YM0800XMental Health CounselorCC4951ME
2101YA0400XAddiction (Substance Use Disorder) CounselorLC7341ME

General Provider Information

NPI Number : 1992188783
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANAMARIE LASSELLE LCPC, LADC, CCS
Provider Business Mailing Address
First Line : 17 BISHOP ST
Second Line :
City : PORTLAND
State : ME
Zip : 04103-2659
Country : US
Telephone Number : 207-756-3719
Fax Number : 207-517-5077
Provider Business Practice Location Address
First Line : 17 BISHOP ST
Second Line :
City : PORTLAND
State : ME
Zip : 04103-2659
Country : US
Telephone Number : 207-203-7933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2015
Last Update Date : 12/11/2025

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