Provider Demographics
NPI:1851639454
Name:LACKEY, STEVEN L (LPC-S)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:L
Last Name:LACKEY
Suffix:
Gender:M
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-1410
Mailing Address - Country:US
Mailing Address - Phone:409-883-9940
Mailing Address - Fax:866-883-6818
Practice Address - Street 1:6901 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-1410
Practice Address - Country:US
Practice Address - Phone:409-883-9940
Practice Address - Fax:866-883-6818
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11455101YA0400X
TX67594101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX043840001OtherTAX ID
TX361920701Medicaid