Ethan Kent Lacey

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5193 Issued in MN

Practice address

900 Long Lake Rd Ste 320
New Brighton, MN 55112-6439

Phone

(651) 482-9361

Fax

(651) 482-9888

NPI assigned

Nov 11, 2022

Sex

Male

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

Mental Health Counselor

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Arden Woods Psychological Services PAGroup PAC ID 3173429214, 15 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 and National Provider Directory roles.

• Arden Woods Psychological Services PA

  • Clinical Psychologist
  • New Brighton, MN
  • NPI 1669576278
  Medicare reassignment Care Compare group NPD
• Lacey Psychotherapy, PA

  • Professional Counselor
  • New Brighton, MN
  • NPI 1366323115
  NPD Authorized official

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

{
    "created_epoch": "1668124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1881302479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 LONG LAKE RD STE 320",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126439",
            "telephone_number": "651-482-9361",
            "fax_number": "651-482-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 LONG LAKE RD STE 320",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126439",
            "telephone_number": "651-482-9361",
            "fax_number": "651-482-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACEY",
        "first_name": "ETHAN",
        "middle_name": "KENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-11",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "5193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Christine Kraemer, PSY.D., LP
• Darrnell Dee Krell, LADC
• Kristine Lutz Counseling PLLC
• Heather Kunkel
• Lacey Psychotherapy, PA
• Alissa Marie Lambrides, BA, MA
• Sherrie L Lange, PT
• Stephen Langemo, RPH
• Thomas M Latimer, LICSW
• Latitudes Treatment Center LLC

• Professional Counselor in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.
• 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.