Provider Demographics
NPI:1841802691
Name:COLON-LACEY, ALICE MERCEDES (PHD, LBS)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:MERCEDES
Last Name:COLON-LACEY
Suffix:
Gender:F
Credentials:PHD, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 PHILIP DR
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1888
Mailing Address - Country:US
Mailing Address - Phone:215-280-6620
Mailing Address - Fax:
Practice Address - Street 1:833 E BUTLER AVE
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2280
Practice Address - Country:US
Practice Address - Phone:215-340-1500
Practice Address - Fax:215-345-3529
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health