Provider Demographics
NPI:1437340742
Name:LACY, CRAIG E (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:E
Last Name:LACY
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-4313
Mailing Address - Country:US
Mailing Address - Phone:610-805-7720
Mailing Address - Fax:610-239-9085
Practice Address - Street 1:1220 VALLEY FORGE ROAD
Practice Address - Street 2:BLDG B SUITE 2
Practice Address - City:VALLEY FORGE
Practice Address - State:PA
Practice Address - Zip Code:19480
Practice Address - Country:US
Practice Address - Phone:610-805-7720
Practice Address - Fax:610-933-8019
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001431101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional