Individual provider Active NPI

Lorrie Lashell Dallas, SACIT

  • Addiction (Substance Use Disorder) Counselor
  • Milwaukee, WI
National Provider Identifier
1578886586
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
15459 130 Issued in WI
Practice address
5600 W Brown Deer Rd
Suite 110
Milwaukee, WI 53223-2311
Phone
(414) 810-6691
Fax
(866) 719-3024
NPI assigned
Mar 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15459 130 WI Primary

Addresses

Primary practice location

5600 W Brown Deer Rd
Suite 110
Milwaukee, WI 53223-2311

Mailing address

912 W Nash St
Milwaukee, WI 53206-3345
Phone (414) 397-9213

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

State licenses

LicenseStateTypeSpecialty
15459 130WIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1578886586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 W NASH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532063345",
            "telephone_number": "414-397-9213",
            "fax_number": "414-354-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 W BROWN DEER RD",
            "address_2": "SUITE 110",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532232311",
            "telephone_number": "414-810-6691",
            "fax_number": "866-719-3024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLAS",
        "first_name": "LORRIE",
        "middle_name": "LASHELL",
        "credential": "SACIT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-04",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15459 130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.