Individual provider Active NPI

Danielle Lacy, LMSW U/S

  • Mental Health Counselor
  • Tulsa, OK
National Provider Identifier
1114377215
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
6216 S Lewis Ave
Ste 180
Tulsa, OK 74136-1077
Phone
(918) 960-7852
Fax
(539) 664-5738
NPI assigned
Jun 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

6216 S Lewis Ave
Ste 180
Tulsa, OK 74136-1077

Mailing address

6216 S Lewis Ave
Ste 180
Tulsa, OK 74136-1077
Phone (918) 960-7852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190228000725 OK Practitioner - Clinical Social Worker 1052650587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2530 S Commerce St
BLDG B
Ardmore, OK 73401-5519
Phone (580) 223-5636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6670OKMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Behavioral Wellness Centers CurrentSince Apr 16, 2024 Accepting new patients
Lighthouse Behavioral Wellness Centers Current Accepting new patients

Locations

2530 S Commerce St
Bldg B
Ardmore, OK 73401
Phone (580) 319-7305

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1114377215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6216 S LEWIS AVE",
            "address_2": "STE 180",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361077",
            "telephone_number": "918-960-7852",
            "fax_number": "539-664-5738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6216 S LEWIS AVE",
            "address_2": "STE 180",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361077",
            "telephone_number": "918-960-7852",
            "fax_number": "539-664-5738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACY",
        "first_name": "DANIELLE",
        "credential": "LMSW U/S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.