Lacie L Anthony, LPC
Individual provider Active NPI Professional Counselor · Prairie Du Chien, WI
NPI 1679503239 · NPPES record last updated Jun 15, 2021
Key facts
- NPI
- 1679503239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 3444 (WI)
- Practice address
- 37868 US Highway 18
Prairie Du Chien, WI 53821-8416 - Phone
- (608) 357-2000
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240304003544 | WI | Practitioner - Mental Health Counselor | 2961847645 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3444 | WI | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prairie Du Chien Memorial Hospital Association Inc | Current |
Accepting new patients |
Locations
37868 US Highway 18
Prairie du Chien, WI 53821
Phone (608) 357-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3444 | WI | Yes |
Addresses
Primary practice location
37868 US Highway 18
Prairie Du Chien, WI 53821-8416
Mailing address
37868 US Highway 18
Prairie Du Chien, WI 53821-8416
Phone (608) 357-2000
Other practice location 1
800 E Blackhawk Avenue
Prairie du Chien, WI 53821
Phone (608) 326-0808
Other practice location 2
1910 South Ave
LA Crosse, WI 54601
Phone (608) 782-7300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40959200 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/ | Direct | |
| Direct Messaging Address | lanthony18458@direct.monroeclinic.org | Direct | The Monroe Clinic, Inc. |
| FHIR URL | https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/ | Other |
Other providers in Prairie Du Chien, WI
- Allied Horsemanship, Inc
- Javier Alvarez
- Paul Manton Barrineau
- Rebecca Lynne Bartels
- Sarah Benjamin
- Lisa L Bierman
- Marilu Bintz
All providers in Prairie Du Chien, WI · Professional Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.