Provider Demographics
NPI:1710002100
Name:LEHMAN, LACY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LACY
Middle Name:
Last Name:LEHMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LACY
Other - Middle Name:
Other - Last Name:ECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:850 EAST YOUNG ST
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-5736
Mailing Address - Country:US
Mailing Address - Phone:208-223-8780
Mailing Address - Fax:208-242-3892
Practice Address - Street 1:850 EAST YOUNG ST
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-5736
Practice Address - Country:US
Practice Address - Phone:208-223-8780
Practice Address - Fax:208-242-3892
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-318851041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807366600Medicaid