Provider Demographics
NPI:1669880985
Name:GARTLEY, LACEY (MMFT)
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:
Last Name:GARTLEY
Suffix:
Gender:F
Credentials:MMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 COUNTY SERVICES RD
Mailing Address - Street 2:STE 100
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-1748
Mailing Address - Country:US
Mailing Address - Phone:615-463-6168
Mailing Address - Fax:615-463-6162
Practice Address - Street 1:162 COUNTY SERVICES RD
Practice Address - Street 2:STE 100
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-1748
Practice Address - Country:US
Practice Address - Phone:615-463-6168
Practice Address - Fax:615-463-6162
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health