Provider Demographics
NPI:1407348667
Name:LA CASSE, MICHELLE (LPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:LA CASSE
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 2ND AVE SW STE 102
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2483
Mailing Address - Country:US
Mailing Address - Phone:541-286-3209
Mailing Address - Fax:541-704-0040
Practice Address - Street 1:425 2ND AVE SW STE 102
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2483
Practice Address - Country:US
Practice Address - Phone:541-286-3209
Practice Address - Fax:541-704-0040
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC9675OtherLICENSE