Individual provider Active NPI

Cheryl Lynn Lacey, LICSW

  • Clinical Social Worker
  • Providence, RI
National Provider Identifier
1053679779
Registry record updated Nov 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW02413 Issued in RI
Practice address
10 Dorrance St Ste 700
Providence, RI 02903-2014
Phone
(888) 500-2067
NPI assigned
May 1, 2012
Last updated
Nov 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW01484 RI
Clinical Social Worker 1041C0700X 218558 MA
Clinical Social Worker 1041C0700X ISW02413 RI Primary

Addresses

Primary practice location

10 Dorrance St Ste 700
Providence, RI 02903-2014

Mailing address

105 Town Farm Rd
Pascoag, RI 02859-2405
Phone (401) 862-7850

Other practice location 1

93 Paris Irons Rd
Chepachet, RI 02814-2135
Phone (401) 862-7850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW01484RIMDClinical Social Worker
ISW02413RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793836800000",
    "number": "1053679779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 TOWN FARM RD",
            "city": "PASCOAG",
            "state": "RI",
            "postal_code": "028592405",
            "telephone_number": "401-862-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DORRANCE ST STE 700",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029032014",
            "telephone_number": "888-500-2067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "93 Paris Irons Rd",
            "address_purpose": "LOCATION",
            "city": "Chepachet",
            "state": "RI",
            "postal_code": "028142135",
            "country_code": "US",
            "telephone_number": "401-862-7850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACEY",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-01",
        "last_updated": "2026-11-05",
        "certification_date": "2026-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "CSW01484",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "218558",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2026; 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.