Provider Demographics
NPI:1609052869
Name:MASHINTER, LACEY (LCSW)
Entity Type:Individual
Prefix:
First Name:LACEY
Middle Name:
Last Name:MASHINTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 400
Mailing Address - Street 2:
Mailing Address - City:COTOPAXI
Mailing Address - State:CO
Mailing Address - Zip Code:81223
Mailing Address - Country:US
Mailing Address - Phone:719-285-5121
Mailing Address - Fax:719-218-9994
Practice Address - Street 1:8671 SOUTH QUEBEC ST
Practice Address - Street 2:STE 200
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130
Practice Address - Country:US
Practice Address - Phone:888-852-6672
Practice Address - Fax:305-891-4228
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO99124335Medicaid
COC0300980Medicare PIN