| Mr Michael Glen Laster, LPC | |
|
32 Court St Ste 7, Plymouth, MA 02360-8733 | |
| (781) 287-8676 | |
| (800) 593-2560 |
| Full Name | Mr Michael Glen Laster |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 23 Years |
| Location | 32 Court St Ste 7, Plymouth, Massachusetts |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528404654 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 10004583 (Massachusetts) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Boodah, Inc | 8224361332 | 3 |
| Entity Name | Boodah, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104390525 PECOS PAC ID: 8224361332 Enrollment ID: O20190605000184 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Michael Glen Laster, LPC 1430 Collier St, Austin, TX 78704-2911 Ph: (512) 445-7787 | Mr Michael Glen Laster, LPC 32 Court St Ste 7, Plymouth, MA 02360-8733 Ph: (781) 287-8676 |
Paul D'espinoza, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 39a Industrial Park Rd, Plymouth, MA 02360 Phone: 508-830-1444 Fax: 508-830-3655 |
Sarah A Benton, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 34 Main Street Ext, Suite 103, Plymouth, MA 02360 Phone: 508-830-0012 Fax: 508-830-0092 |
Charles Ruisi, Counselor Medicare: Not Enrolled in Medicare Practice Location: 430 Court St, Plymouth, MA 02360 Phone: 617-750-4983 |
Ms. Barbara Ann Capaldo, MED Counselor Medicare: Not Enrolled in Medicare Practice Location: 61 Industrial Park Rd, South Bay Mental Health Center, Plymouth, MA 02360 Phone: 508-830-0000 Fax: 508-746-8429 |
Kelly Marie Williams, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 118 Long Pond Rd, Plymouth, MA 02360 Phone: 508-747-7783 Fax: 508-747-7838 |
Tiffanie Foster, Counselor Medicare: Not Enrolled in Medicare Practice Location: 61 Industrial Park Rd, Plymouth, MA 02360 Phone: 774-628-1000 |
George D Affonso, LADC I, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 60 Cherry St, Plymouth, MA 02360 Phone: 508-746-6654 Fax: 508-746-2433 |