Channing Renee Lackey

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

222 W 6TH St
Corona, CA 92882-3301

Phone

(888) 682-6282

NPI assigned

Mar 4, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Social Model Recovery Systems, Inc.

  • Community/Behavioral Health Agency
  • Pomona, CA
  • NPI 1447615539

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1104384635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13267 ROSWELL AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917104771",
            "telephone_number": "909-680-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W 6TH ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823301",
            "telephone_number": "888-682-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "CHANNING",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charalambos Andreas Kyriacou, PSY.D.
• La Familia and Womens Medical Clinic Inc
• Derek Oai La, PHARM. D.
• Francesca Lacava
• Jacquelyn V Lacera, MD
• Ama Lindiwe Lacy, MD
• Samantha Ladd
• Xiomara Rosa Lago, RNNP
• Gregory Lai, DDS
• James Kok-Kai Lai, DDS

• Addiction (Substance Use Disorder) Counselor in Corona, CA
• Providers in Corona, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.