Organization Active NPI

Carmen Lasby PLLC

Doing business as Carmen Lasby PsyD

  • Psychologist
  • Bellevue, WA
National Provider Identifier
1548728744
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
CARMEN LASBY PLLC
Doing business as
Carmen Lasby PsyD
Practice address
2105 112TH Ave NE Ste 200
Bellevue, WA 98004-2945
Phone
(253) 642-6358
NPI assigned
Mar 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Authorized official

Name
Dr. Carmen Danielle Lasby, PSYDNPI 1780066381
Title
Licensed Psychologist
Phone
(253) 642-6358

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary
Community/Behavioral Health Agency 251S00000X
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

2105 112TH Ave NE Ste 200
Bellevue, WA 98004-2945

Mailing address

PO Box 60223
Renton, WA 98058-3223
Phone (253) 642-6358

Other practice location 1

1412 SW 43rd St Ste 240C
Renton, WA 98057-4803
Phone (253) 642-6358

Other names 1

  • Carmen Lasby PsyD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190624002774 WA Part B Supplier - Clinic/Group Practice 7113251232 Receives reassigned benefits from 1 practitioner
Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory

Locations

1412 SW 43rd St
Ste 240C
Renton, WA 98057
Phone (253) 642-6358

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1548728744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60223",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980583223",
            "telephone_number": "253-642-6358",
            "fax_number": "425-207-4932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 112TH AVE NE STE 200",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042945",
            "telephone_number": "253-642-6358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1412 SW 43rd St Ste 240C",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980574803",
            "country_code": "US",
            "telephone_number": "253-642-6358",
            "fax_number": "425-207-4932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CARMEN LASBY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-06",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "LASBY",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "253-642-6358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carmen Lasby PsyD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.