| Lacey Trent Lmsw Llc | |
|
1312 N Campbell Rd Ste 22 Royal Oak MI 48067-1555 | |
| (562) 652-9744 | |
| Not Available |
| Full Name | Lacey Trent Lmsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1312 N Campbell Rd Ste 22, Royal Oak, Michigan |
| Authorized Official Name and Position | Lacey Trent (LMSW/THERAPIST) |
| Authorized Official Contact | 5626529744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lacey Trent Lmsw Llc 1312 N Campbell Rd Ste 22 Royal Oak MI 48067-1555 Ph: (562) 652-9744 | Lacey Trent Lmsw Llc 1312 N Campbell Rd Ste 22 Royal Oak MI 48067-1555 Ph: (562) 652-9744 |
| NPI Number | 1154105112 |
|---|---|
| Provider Enumeration Date | 08/22/2023 |
| Last Update Date | 08/31/2023 |
| Certification Date | 08/31/2023 |
| Medicare PECOS PAC ID | 7719335710 |
|---|---|
| Medicare Enrollment ID | O20231201001437 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154105112 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lacey Trent |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538593322 PECOS PAC ID: 5799106696 Enrollment ID: I20220719002437 |
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