| Ingrid J Lacey, Llc | |
|
1799 Clairmont Rd Decatur GA 30033-4005 | |
| (404) 490-0664 | |
| Not Available |
| Full Name | Ingrid J Lacey, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1799 Clairmont Rd, Decatur, Georgia |
| Authorized Official Name and Position | Ingrid Jennifer Lacey (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 4159138831 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ingrid J Lacey, Llc 2156 Cavanaugh Ave Se Atlanta GA 30316-2706 Ph: (415) 913-8831 | Ingrid J Lacey, Llc 1799 Clairmont Rd Decatur GA 30033-4005 Ph: (404) 490-0664 |
| NPI Number | 1831681428 |
|---|---|
| Provider Enumeration Date | 05/31/2018 |
| Last Update Date | 05/31/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831681428 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 008680 (Georgia) | Primary |
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