Provider Demographics
NPI:1447542329
Name:LASSELL, KAREN L (MFT)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:LASSELL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2356 MINARET DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4914
Mailing Address - Country:US
Mailing Address - Phone:925-372-3746
Mailing Address - Fax:
Practice Address - Street 1:2356 MINARET DR
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4914
Practice Address - Country:US
Practice Address - Phone:925-372-3746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMN19567106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist