Individual provider Active NPI

Lacy Detterich, LMHC

  • Mental Health Counselor
  • Indianapolis, IN
National Provider Identifier
1588867543
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39001872A Issued in IN
Practice address
8320 Madison Ave
Indianapolis, IN 46227-6066
Phone
(317) 882-5122
Fax
(317) 888-8642
NPI assigned
Jun 7, 2007
Last updated
Mar 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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 39001872A IN Primary

Addresses

Primary practice location

8320 Madison Ave
Indianapolis, IN 46227-6066

Mailing address

2885 W Battlefield St
Springfield, MO 65807-3952
Phone (317) 882-5122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20260414000558 IN Practitioner - Mental Health Counselor 5991270365 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

645 S Rogers St
Bloomington, IN 47403-2353

8320 Madison Ave
Indianapolis, IN 46227-6090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39001872AINMDMental Health Counselor

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1588867543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 W BATTLEFIELD ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658073952",
            "telephone_number": "317-882-5122",
            "fax_number": "317-888-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 MADISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462276066",
            "telephone_number": "317-882-5122",
            "fax_number": "317-888-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTERICH",
        "first_name": "LACY",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001872A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.