Active NPI
Judy Durrah Lassiter, MA
- Mental Health Counselor
- Columbia, SC
National Provider Identifier
1396043618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- SC LPC 5254
- Practice address
- 2712 Middleburg Dr
Suite 206
Columbia, SC 29204-2415 - Phone
- (803) 779-0354
- Fax
- (803) 779-0119
- NPI assigned
- Mar 10, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | SC LPC 5254 | SC | Primary |
Addresses
Primary practice location
2712 Middleburg Dr
Suite 206
Columbia, SC 29204-2415
Mailing address
2712 Middleburg Dr
Suite 206
Columbia, SC 29204-2415
Phone (803) 779-0354
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 582444986 | Other | SC | PRIVATE INSURANCE |
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC LPC 5254 | SC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299715200000",
"number": "1396043618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2712 MIDDLEBURG DR",
"address_2": "SUITE 206",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292042415",
"telephone_number": "803-779-0354",
"fax_number": "803-779-0119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2712 MIDDLEBURG DR",
"address_2": "SUITE 206",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292042415",
"telephone_number": "803-779-0354",
"fax_number": "803-779-0119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LASSITER",
"first_name": "JUDY",
"middle_name": "DURRAH",
"name_prefix": "Ms.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-10",
"last_updated": "2011-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "SC",
"license": "SC LPC 5254",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIVATE INSURANCE",
"identifier": "582444986",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.