| Matthew Aaron Lasslo, | |
|
463 S Lake Powell Blvd, Page, AZ 86040-0856 | |
| (928) 645-5113 | |
| (928) 645-3254 |
| Full Name | Matthew Aaron Lasslo |
|---|---|
| Gender | Male |
| Speciality | Counselor |
| Location | 463 S Lake Powell Blvd, Page, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003426545 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | LAC-17209 (Arizona) | Primary |
| Entity Name | Creek Valley Health Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821652793 PECOS PAC ID: 0042542706 Enrollment ID: O20191029003356 |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew Aaron Lasslo, Po Box 790, Page, AZ 86040-0790 Ph: (928) 645-5113 | Matthew Aaron Lasslo, 463 S Lake Powell Blvd, Page, AZ 86040-0856 Ph: (928) 645-5113 |
Mr. Norman Ray Stevens, LISAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 337 N. Navajo Drive, Page, AZ 86040 Phone: 928-645-6840 Fax: 928-645-8158 | |
Peggy Fuhrman, MASTERS EDUCATION Counselor Medicare: Not Enrolled in Medicare Practice Location: 500 S. Navajo, Page, AZ 86040 Phone: 928-608-4200 Fax: 928-645-5059 | |
Mr. John Valvo, BA, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 463 S. Lake Powell Blvd, Page, AZ 86040 Phone: 928-645-5113 Fax: 928-645-3254 | |
Irene B Jones, M.ED. Counselor Medicare: Not Enrolled in Medicare Practice Location: 434 S Lake Powell Blvd, Page, AZ 86040 Phone: 928-608-4170 Fax: 928-645-9243 | |
Mrs. Beverly Jean Horton, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 463 S. Lake Powell Blvd, Page, AZ 86040 Phone: 928-645-5113 | |
Mrs. Virginia Arizona-fat, LISAC,CPS Counselor Medicare: Not Enrolled in Medicare Practice Location: 337 N. Navajo Drive, Page, AZ 86040 Phone: 928-645-6480 Fax: 928-645-8158 |