Mark Irwin Lackmann, LADAC I; CADC I

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LDC0000001357 Issued in TN

Practice address

661 Madison Ave
Memphis, TN 38103-3307

Phone

(901) 267-4008

NPI assigned

Nov 17, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1700179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1689449803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3045 LEERIDGE DR",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381343613",
            "telephone_number": "505-402-3138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033307",
            "telephone_number": "901-267-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKMANN",
        "first_name": "MARK",
        "middle_name": "IRWIN",
        "credential": "LADAC I; CADC I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "TN-006",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "LDC0000001357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Michael Lachina, M.D.
• Elvin Lackey
• Mark A Lackey, DMD
• Catherine Talbot Lackie, FNP
• Richard Malone Lackie, D.D.S.
• Lacy and Bradford Care Facility
• Lacy Care Facility
• Michael R Lacy, MD
• Susan Northern Lacy, MD
• Wayne Joseph Ladner Jr., P.A.

• Addiction (Substance Use Disorder) Counselor in Memphis, TN
• Providers in Memphis, TN by specialty
• Addiction (Substance Use Disorder) Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.