Individual provider Active NPI

Lacey Ann Hancock, LCMHC

  • Mental Health Counselor
  • Midvale, UT
National Provider Identifier
1407360951
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8756352-6004 Issued in UT
Practice address
613 E Fort Union Blvd Ste 104
Midvale, UT 84047
Phone
(801) 984-1717
Fax
(801) 984-1720
NPI assigned
Nov 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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 8756352-6004 UT Primary

Addresses

Primary practice location

613 E Fort Union Blvd Ste 104
Midvale, UT 84047

Mailing address

613 E Fort Union Blvd Ste 104
Midvale, UT 84047-5531
Phone (801) 984-1717

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8756352-6004UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Life Stone Group, LLC Past Accepting new patients

Organizations & group practices 1

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": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1407360951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 E FORT UNION BLVD STE 104",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840475531",
            "telephone_number": "801-984-1717",
            "fax_number": "801-984-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 E FORT UNION BLVD STE 104",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "84047",
            "telephone_number": "801-984-1717",
            "fax_number": "801-984-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "LACEY",
        "middle_name": "ANN",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "8756352-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.