| Lace Counseling Center,llc | |
|
777 W Jackson St Marshfield MO 65706-2218 | |
| (417) 840-3970 | |
| (417) 859-4429 |
| Full Name | Lace Counseling Center,llc |
|---|---|
| Speciality | Counselor |
| Location | 777 W Jackson St, Marshfield, Missouri |
| Authorized Official Name and Position | Daryl Eugene Lace (DIRECOR) |
| Authorized Official Contact | 4178403970 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lace Counseling Center,llc 821 E Burford St Marshfield MO 65706-1305 Ph: (417) 840-3970 | Lace Counseling Center,llc 777 W Jackson St Marshfield MO 65706-2218 Ph: (417) 840-3970 |
| NPI Number | 1568237014 |
|---|---|
| Provider Enumeration Date | 11/15/2023 |
| Last Update Date | 11/15/2023 |
| Certification Date | 11/15/2023 |
| Medicare PECOS PAC ID | 6103261078 |
|---|---|
| Medicare Enrollment ID | O20240301000457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568237014 | NPI | - | NPPES |
| Provider Name | Daryl Lace |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194916312 PECOS PAC ID: 3274978143 Enrollment ID: I20240301000580 |
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