Lacey Anne Trimble, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

078352-1 Issued in NY

Practice address

146 Pike St
Port Jervis, NY 12771-1808

Phone

(845) 291-2604

NPI assigned

Dec 6, 2006

Last updated

Feb 28, 2011By 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 1

Addresses

Other names 1

• Lacey Anne Brother Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298851200000",
    "number": "1114086139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 PIKE ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127711808",
            "telephone_number": "845-291-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 PIKE ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127711808",
            "telephone_number": "845-291-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIMBLE",
        "first_name": "LACEY",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2011-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078352-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACEY",
            "last_name": "BROTHER",
            "middle_name": "ANNE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eugenia Marie Tice-Shepard, PT,DPT
• Agnes Timberger, LISCENSED MASTER SOC
• Muhlise Dide Tosyali, D.M.D.
• Tri-State Emergency Physicians PLLC
• Tri-State Radiology, P.C.
• Jenna Trone
• Twin Rivers Gastroenterology, LLP
• Caroline Ellen Van Patten, M.S., CCC-SLP
• Breanna Nicole Vandyk, NP
• Jessica Velez

• Clinical Social Worker in Port Jervis, NY
• Providers in Port Jervis, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2011; 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.