Sara Bourne Lacy, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P.7380 Issued in OH

Practice address

3200 Tremont Rd
Upper Arlington, OH 43221-2040

Phone

(614) 293-9777

Fax

(614) 293-9677

NPI assigned

Nov 17, 2015

Last updated

Feb 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: slacy702993@direct.osumc.edu

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.

• Osu General Internal Medicine LLC

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1689919599

  Psychologist

  Medicare reassignment NPD

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1619341468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-9777",
            "fax_number": "614-293-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 TREMONT RD",
            "city": "UPPER ARLINGTON",
            "state": "OH",
            "postal_code": "432212040",
            "telephone_number": "614-293-9777",
            "fax_number": "614-293-9677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Kenny Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432213555",
            "country_code": "US",
            "telephone_number": "614-293-5123",
            "fax_number": "614-293-4980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACY",
        "first_name": "SARA",
        "middle_name": "BOURNE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-17",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "P.7380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slacy702993@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "2000 Kenny Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432213555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly M. Kopfman, CPNP
• Stephen S Koppes, P.A.-C
• Kristina L Edler, LLC
• Jennifer Nicole Krizman, PT
• Scott Daniel Kuhn, PT
• Kiran Mayee Lakkarajula Subuddi
• Nicholas Josef Latorre, PA-C
• James Charles Latshaw, MD
• Brooke Laturell
• Sally Lee

• Clinical Psychologist in Upper Arlington, OH
• Providers in Upper Arlington, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.