Provider Demographics
NPI:1548831241
Name:LASSITER, ALANA (CDCA)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:LASSITER
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2882 SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2270
Mailing Address - Country:US
Mailing Address - Phone:614-649-4555
Mailing Address - Fax:
Practice Address - Street 1:1579 S HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-1804
Practice Address - Country:US
Practice Address - Phone:614-826-0002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-05
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YA0400X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No133N00000XDietary & Nutritional Service ProvidersNutritionist