Provider Demographics
NPI:1093068157
Name:LASICH, SADAH ELAINE (EDS)
Entity type:Individual
Prefix:MS
First Name:SADAH
Middle Name:ELAINE
Last Name:LASICH
Suffix:
Gender:
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3219 S FAWN ST
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-8466
Mailing Address - Country:US
Mailing Address - Phone:405-249-2236
Mailing Address - Fax:
Practice Address - Street 1:3219 S FAWN ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-8466
Practice Address - Country:US
Practice Address - Phone:405-249-2236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional