Lacey Allen, RASAC I

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Kennett, MO

NPI 1497900120 · NPPES record last updated Nov 21, 2008

Key facts

NPI
1497900120
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
103 S Main St
Suite C
Kennett, MO 63857-3039
Phone
(573) 888-1844
Fax
(573) 888-6958
NPI assigned
Nov 21, 2008
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

103 S Main St
Suite C
Kennett, MO 63857-3039

Mailing address

103 S Main St
Suite C
Kennett, MO 63857-3039
Phone (573) 888-1844

Other providers in Kennett, MO

All providers in Kennett, MO · Addiction (Substance Use Disorder) Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.