Lacy Clayton Wellness

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

LACY CLAYTON WELLNESS

Practice address

102 Waverly Rd
Wyncote, PA 19095-1322

Phone

(267) 944-6220

NPI assigned

Sep 8, 2023

Last updated

Sep 8, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lacy Rae Clayton, DNP PMHNP-BCNPI 1508166281

Title

Owner

Phone

(267) 944-6220

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lacy Rae Clayton, RN, NP, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wyncote, PA
  • NPI 1508166281
  NPD Authorized official

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694131200000",
    "number": "1073390621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WAVERLY RD",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "190951322",
            "telephone_number": "267-944-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WAVERLY RD",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "190951322",
            "telephone_number": "267-944-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LACY CLAYTON WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "LACY",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-944-6220",
        "authorized_official_credential": "DNP PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Wyncote, PA
• Providers in Wyncote, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.