| Maureen K. Lassen, Ph.d., P.c. | |
|
1234 S Power Rd Suite 254 Mesa AZ 85206-3700 | |
| (480) 785-0525 | |
| (480) 656-4528 |
| Full Name | Maureen K. Lassen, Ph.d., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 1234 S Power Rd, Mesa, Arizona |
| Authorized Official Name and Position | Maureen Lassen (PRESIDENT) |
| Authorized Official Contact | 4807850525 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maureen K. Lassen, Ph.d., P.c. 1234 S Power Rd Suite 254 Mesa AZ 85206-3700 Ph: (480) 785-0525 | Maureen K. Lassen, Ph.d., P.c. 1234 S Power Rd Suite 254 Mesa AZ 85206-3700 Ph: (480) 785-0525 |
| NPI Number | 1558663716 |
|---|---|
| Provider Enumeration Date | 11/21/2010 |
| Last Update Date | 12/20/2019 |
| Certification Date | 12/20/2019 |
| Medicare PECOS PAC ID | 4789869975 |
|---|---|
| Medicare Enrollment ID | O20110503000853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558663716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 691 (Arizona) | Primary |
| Provider Name | Maureen Lassen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275687725 PECOS PAC ID: 1850347527 Enrollment ID: I20050324001297 |
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