Michael Albin Lace, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

33333 Issued in WI

Practice address

2141 Altoona Ave
Eau Claire, WI 54701

Phone

(715) 552-7350

Fax

(715) 878-9075

NPI assigned

Mar 20, 2007

Last updated

Sep 16, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Christian Community Resources, LLC

  dba Freedom Counseling

  • Clinical Psychologist
  • Eau Claire, WI
  • NPI 1104026665
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1023133022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 ALTOONA AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "54701",
            "telephone_number": "715-552-7350",
            "fax_number": "715-878-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACE",
        "first_name": "MICHAEL",
        "middle_name": "ALBIN",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "33333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39365600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Kwosek
• Julia Kyle, MD
• Perry Leroy Kyser, MD
• Abigail Terese La Nou, MD
• Kristine Patricia Laberge, DNP, APNP
• Ciara G Ladick, M.S. SLP
• David John Ladin, M.D.
• Kathryn E Lafans, DO
• Emily Lynn Lagesse
• Jay Laguardia, DC

• Psychologist in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.