Individual provider Active NPI

Marcus Lasota, PH.D.

  • Clinical Psychologist
  • Washington, DC
National Provider Identifier
1104372069
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY1000652 Issued in DC
Practice address
4001 Harewood Rd NE
110 O'Boyle Hall
Washington, DC 20017-1508
Phone
(702) 232-2774
NPI assigned
Aug 31, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY1000652 DC Primary

Addresses

Primary practice location

4001 Harewood Rd NE
110 O'Boyle Hall
Washington, DC 20017-1508

Mailing address

4001 Harewood Rd NE
110 O'Boyle Hall
Washington, DC 20017-1508
Phone (702) 232-2774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY1000652DCMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1104372069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 HAREWOOD RD NE",
            "address_2": "110 O'BOYLE HALL",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200171508",
            "telephone_number": "702-232-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 HAREWOOD RD NE",
            "address_2": "110 O'BOYLE HALL",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200171508",
            "telephone_number": "702-232-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASOTA",
        "first_name": "MARCUS",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1000652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.