Individual provider Active NPI

Lacy Fay Otoole

  • Peer Specialist
  • Hicksville, NY
National Provider Identifier
1174428064
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
1114928462 Issued in NY
Practice address
950 S Oyster Bay Rd
Hicksville, NY 11801-3511
Phone
(516) 390-6544
NPI assigned
Oct 10, 2026
Last updated
Oct 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 1114928462 NY Primary

Addresses

Primary practice location

950 S Oyster Bay Rd
Hicksville, NY 11801-3511

Mailing address

426 Mansfield Ave
Levittown, NY 11756-5616
Phone (516) 390-6544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1791590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1174428064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 MANSFIELD AVE",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117565616",
            "telephone_number": "516-390-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 S OYSTER BAY RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013511",
            "telephone_number": "516-390-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTOOLE",
        "first_name": "LACY",
        "middle_name": "FAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-10",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NY",
            "license": "1114928462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.