Provider Demographics
NPI:1164035424
Name:MAGGS, LACEY MELODY (LSW)
Entity Type:Individual
Prefix:
First Name:LACEY
Middle Name:MELODY
Last Name:MAGGS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:DUNCANNON
Mailing Address - State:PA
Mailing Address - Zip Code:17020-1330
Mailing Address - Country:US
Mailing Address - Phone:717-636-1950
Mailing Address - Fax:
Practice Address - Street 1:155 S HANOVER ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3455
Practice Address - Country:US
Practice Address - Phone:717-386-5971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1373321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical