Lacy Elizabeth Moon, MSW U/S, LMSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5836-P Issued in OK

Practice address

400 E Sycamore St
Hollis, OK 73550-1436

Phone

(580) 688-2800

NPI assigned

Dec 21, 2012

Last updated

Mar 20, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1356048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1639415581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E SYCAMORE ST",
            "city": "HOLLIS",
            "state": "OK",
            "postal_code": "735501436",
            "telephone_number": "580-688-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E SYCAMORE ST",
            "city": "HOLLIS",
            "state": "OK",
            "postal_code": "735501436",
            "telephone_number": "580-688-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "LACY",
        "middle_name": "ELIZABETH",
        "credential": "MSW U/S, LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-21",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "5836-P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson County Memorial Hospital Authority (Harmon Memorial Hospital)
• Jackson County Memorial Hospital Authority (Harmon Memorial Hospital)
• Jackson County Memorial Hospital Authority (JCMH Rural Health Clinic of Hollis)
• William J Kok, MD
• Troy Metheny Jr., BMIN
• Terry L Owens, MBA
• Richard W. Schafer, D.O., Inc
• Robinson Family Pharmacy (Clinic Pharmacy)
• Robinson Family Pharmacy LLC
• Ashley Lynn Robinson, M.S.

• Mental Health Counselor in Hollis, OK
• Providers in Hollis, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; 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.