Provider Demographics
NPI:1508307893
Name:LACY, SARAH (LPCC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LACY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20525 DETROIT RD STE 4
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-2444
Mailing Address - Country:US
Mailing Address - Phone:440-319-6124
Mailing Address - Fax:
Practice Address - Street 1:20525 DETROIT RD STE 4
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-2444
Practice Address - Country:US
Practice Address - Phone:440-319-6124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health