Lacey Hammond

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22081 Issued in MN

Practice address

121 11TH Ave SE
Forest Lake, MN 55025-1850

Phone

(651) 777-5222

Fax

(651) 251-5279

NPI assigned

Jul 6, 2015

Last updated

Jul 6, 2015By 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

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

River Valley Behavioral Health and Wellness Center, PLLCGroup PAC ID 3678625035, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• River Valley Behavioral Health & Wellness Center, PLLC

  • Counseling Psychologist
  • Savage, MN
  • NPI 1316197148
  Medicare reassignment Care Compare group NPD
• Canvas Health, Inc.

  • Mental Health Counselor
  • Oakdale, MN
  • NPI 1922051325
  Medicare reassignment NPD
• Canvas Health, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Forest Lake, MN
  • NPI 1528129574
  NPD (past)

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436140800000",
    "number": "1720461064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 11TH AVE SE",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550251850",
            "telephone_number": "651-777-5222",
            "fax_number": "651-251-5279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 11TH AVE SE",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550251850",
            "telephone_number": "651-777-5222",
            "fax_number": "651-251-5279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOND",
        "first_name": "LACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-06",
        "last_updated": "2015-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Melissa Habedank, LICSW
• Dan John Hagen, RPH
• Halabrin Marty and Associates
• Halabrin Marty and Associates
• Rebecca Jean Halabrin-Marty, PSY.D.
• Carolynn Hanzal
• Greg Edward Harvey, DDS
• Sandra Haselberger, PHARMD
• Ikran Jamal Hassan
• Health Care Psychology, PA

• Clinical Social Worker in Forest Lake, MN
• Providers in Forest Lake, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.