Provider Demographics
NPI:1871726604
Name:LASATER, NANCY (LCSW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LASATER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3875 BIRCHWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-1428
Mailing Address - Country:US
Mailing Address - Phone:393-786-9737
Mailing Address - Fax:
Practice Address - Street 1:3875 BIRCHWOOD DR
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-1428
Practice Address - Country:US
Practice Address - Phone:393-786-9737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9891671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical