Matthew Aaron Lasslo

Individual provider Counselor · NPI 1003426545

Matthew Aaron Lasslo is a Mental Health Counselor in Page, Arizona. Qualified in 2016, 10 years ago. Practices with Creek Valley Health Clinic, a 12-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying: 10
Licensed in: AZ
In the registry since: 2020

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Practice location Address checks out

463 S Lake Powell Blvd
Page, AZ 86040-0856
Phone: (928) 645-5113
Fax: (928) 645-3254

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary)	Taxonomy 101Y00000X · Licence LAC-17209 (AZ)

Record details

NPI number	1003426545
Entity type	Individual (Type 1)
Gender	Male
Sole proprietor	No
NPI enumerated	August 7, 2020
Last updated in NPPES	August 7, 2020
Certification date	August 7, 2020
Mailing address	Po Box 790, Page, AZ 86040-0790

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialty	MENTAL HEALTH COUNSELOR
Medical school	OTHER
Graduated	2016 (10 years in practice)
Group practice	Creek Valley Health Clinic — 12 clinicians
Accepts Medicare assignment	Yes — accepts the Medicare-approved amount