Provider Demographics
NPI:1992188783
Name:LASSELLE, ANAMARIE (LCPC, LADC, CCS)
Entity type:Individual
Prefix:
First Name:ANAMARIE
Middle Name:
Last Name:LASSELLE
Suffix:
Gender:F
Credentials:LCPC, LADC, CCS
Other - Prefix:
Other - First Name:ANAMARIE
Other - Middle Name:
Other - Last Name:DANIELI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:56 NORTHPORT DR STE 101
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-3674
Mailing Address - Country:US
Mailing Address - Phone:207-756-3719
Mailing Address - Fax:207-517-5077
Practice Address - Street 1:56 NORTHPORT DR STE 101
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-3674
Practice Address - Country:US
Practice Address - Phone:207-756-3719
Practice Address - Fax:207-517-5077
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4951101YM0800X
MELC7341101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)