Active NPI
Lacy Dawn Woolsey, LPC
- Professional Counselor
- Mount Vernon, IL
National Provider Identifier
1528308293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178.008751
- Practice address
- 800 S 45TH St
Mount Vernon, IL 62864-6704 - Phone
- (618) 242-3284
- Fax
- (618) 242-3288
- NPI assigned
- Feb 18, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.008751 | IL | Primary |
Addresses
Primary practice location
800 S 45TH St
Mount Vernon, IL 62864-6704
Mailing address
800 S 45TH St
Mount Vernon, IL 62864-6704
Phone (618) 242-3284
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
| License | State | Type | Specialty |
|---|---|---|---|
| 178.008751 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lutheran Child and Family Service of Illinois | Professional | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Mt Vernon, IL
- NPI 1497084347
Professional
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361145600000",
"number": "1528308293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 S 45TH ST",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628646704",
"telephone_number": "618-242-3284",
"fax_number": "618-242-3288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 S 45TH ST",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628646704",
"telephone_number": "618-242-3284",
"fax_number": "618-242-3288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOLSEY",
"first_name": "LACY",
"middle_name": "DAWN",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-18",
"last_updated": "2013-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178.008751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.