Abigail Susan Lacey, MA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

91552 Issued in TX

Practice address

3613 Williams Dr Ste 302
Georgetown, TX 78628-1369

Phone

(512) 713-9886

NPI assigned

Mar 16, 2021

Last updated

Jul 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Impact Counseling Services, Inc.

  • Mental Health Counselor
  • Georgetown, TX
  • NPI 1396312658
  NPD
• Crosspoint United Methodist Church Inc

  • Mental Health Counselor
  • Niceville, FL
  • NPI 1265156459
  NPD (past)

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1033794490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 MALLARD LN",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765423787",
            "telephone_number": "850-603-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3613 WILLIAMS DR STE 302",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786281369",
            "telephone_number": "512-713-9886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Scenic Dr Ste 140",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "TX",
            "postal_code": "786267720",
            "country_code": "US",
            "telephone_number": "512-713-9886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACEY",
        "first_name": "ABIGAIL",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "91552",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "IMH20788",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abigail@impactcounselingservices.org",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3613 Williams Dr Ste 302",
            "city": "Georgetown",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786281369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sharlene Kuo
• Faraz Kureshi, MD, MSC
• Joel Kutnick, MD
• Jung Yeon Kwon
• Shelly Ann Labove, H.I.S.
• Olivia Kay Laessig, BSN, RNC-OB, C-EFM
• Constantina Lalangas, D.D.S
• Julie Lambert, S.L.P.
• Meghan Landry, BCBA
• Jayla Rochelle Lane

• Professional Counselor in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.