Lacey Renee Debusk

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Practice address

337 Trigood Dr
Casper, WY 82609-2227

Phone

(307) 251-7568

NPI assigned

Mar 24, 2020

Last updated

Mar 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Lacey Renee Prill Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1295362960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 TRIGOOD DR",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826092227",
            "telephone_number": "307-251-7568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 TRIGOOD DR",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826092227",
            "telephone_number": "307-251-7568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBUSK",
        "first_name": "LACEY",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACEY",
            "last_name": "PRILL",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard Everett Dayton, DDS MS
• DB Dental LLC
• Trelene Dayna De Fry, MS, LPC 1079
• Gina Marie Debenedetto, O.D.
• Gina Deboer, B.A.
• Shannon C Decker, LPC
• Terra Dayle Deckert
• Karey Suzanne Dedic L Ami, MSOTR L
• Korana L Dedic-Miller
• Amanda Dediego, PHD, LPC, NCC, BC-TM

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Casper, WY
• Providers in Casper, WY by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; 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.