Provider Demographics
NPI:1528403037
Name:LACHENMAYR, STACI M (BA)
Entity Type:Individual
Prefix:MS
First Name:STACI
Middle Name:M
Last Name:LACHENMAYR
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:504 MICAH DR
Mailing Address - Street 2:DRAWER M
Mailing Address - City:OLNEY
Mailing Address - State:IL
Mailing Address - Zip Code:62450-4720
Mailing Address - Country:US
Mailing Address - Phone:618-395-4306
Mailing Address - Fax:618-395-4507
Practice Address - Street 1:204 W HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:ROBINSON
Practice Address - State:IL
Practice Address - Zip Code:62454-1710
Practice Address - Country:US
Practice Address - Phone:618-546-1021
Practice Address - Fax:618-544-7892
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional