Provider Demographics
NPI:1871639377
Name:WESCHE, LACEY MICHELLE (LISW)
Entity Type:Individual
Prefix:MRS
First Name:LACEY
Middle Name:MICHELLE
Last Name:WESCHE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:LACEY
Other - Middle Name:
Other - Last Name:CORL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 PROMENADE DR
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:OH
Mailing Address - Zip Code:43558-1428
Mailing Address - Country:US
Mailing Address - Phone:419-874-0274
Mailing Address - Fax:419-874-9960
Practice Address - Street 1:424 W WOODRUFF AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-5027
Practice Address - Country:US
Practice Address - Phone:419-841-7701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 1201500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health