Kimberly Gay Lacy, M.A. L.M.H.C.A.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC 60117580 Issued in WA

Practice address

9450 Ethan Wade Way SE
Snoqualmie, WA 98065-9520

Phone

(425) 831-2100

Fax

(425) 831-2112

NPI assigned

Jun 29, 2010

Last updated

Jun 29, 2010By 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

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Cowlitz Indian Tribe

  • Clinic/Center
  • Longview, WA
  • NPI 1740562909

  TX

  Medicare reassignment NPD
• Cowlitz Indian Tribe

  dba NorthStar Clinic

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Vancouver, WA
  • NPI 1538412630
  NPD
• Cowlitz Indian Tribe

  • General Practice Physician
  • Longview, WA
  • NPI 1851328447
  NPD (past)

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1215248877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 969",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980650969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9450 ETHAN WADE WAY SE",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980659520",
            "telephone_number": "425-831-2100",
            "fax_number": "425-831-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACY",
        "first_name": "KIMBERLY",
        "middle_name": "GAY",
        "name_prefix": "Mrs.",
        "credential": "M.A. L.M.H.C.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC 60117580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Suzanne Kramer, D.D.S.
• Lisa M Krasowski, PTA
• Nannette Marie Krueger, OTR
• Crystal Labass, PSY.D., LMHC
• Cassandra Labeach
• Erik Lagace, BS
• Karen Lajambe, ARNP
• Lakeside Speech Language and Learning, LLC
• Mary E Lambe, MD FAAFP
• Sheryl Lynn Landstrom

• Mental Health Counselor in Snoqualmie, WA
• Providers in Snoqualmie, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.