Kristine D. Lassiter, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC17971 Issued in ME

Practice address

17 Tink Dr
Gorham, ME 04038-1343

Phone

(978) 210-1807

NPI assigned

May 21, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1942646690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BAXTER BLVD FL 2",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011801",
            "telephone_number": "603-883-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 TINK DR",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381343",
            "telephone_number": "978-210-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASSITER",
        "first_name": "KRISTINE",
        "middle_name": "D.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "LCSW218627",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC17971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Gorham, ME
• Providers in Gorham, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.