Individual provider Active NPI

Lacy Deese, LPC

  • Professional Counselor
  • Ridgeland, MS
National Provider Identifier
1104150093
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1466 Issued in MS
Practice address
199 Charmant PL
Suite 2
Ridgeland, MS 39157-4358
Phone
(601) 670-6444
NPI assigned
Sep 24, 2009
Last updated
Dec 1, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1466 MS Primary

Addresses

Primary practice location

199 Charmant PL
Suite 2
Ridgeland, MS 39157-4358

Mailing address

804 E Leake St
Clinton, MS 39056-4325
Phone (601) 670-6444

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1466MSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rivertree Counseling Associates LLC CurrentSince Oct 2, 2022 Accepting new patients
Lacy M Deese, LLC Professional Past Accepting new patients

Locations

134 Fairmont St
Ste B
Clinton, MS 39056
Phone (601) 397-1554

Organizations & group practices 2

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": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1104150093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 E LEAKE ST",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564325",
            "telephone_number": "601-670-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 CHARMANT PL",
            "address_2": "SUITE 2",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574358",
            "telephone_number": "601-670-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEESE",
        "first_name": "LACY",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-24",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.