Provider Demographics
NPI:1457239394
Name:FARRINGTON, LACEY JORDAN (EDS)
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:JORDAN
Last Name:FARRINGTON
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 Q ST
Mailing Address - Street 2:
Mailing Address - City:GERING
Mailing Address - State:NE
Mailing Address - Zip Code:69341-2972
Mailing Address - Country:US
Mailing Address - Phone:308-436-3123
Mailing Address - Fax:
Practice Address - Street 1:800 Q ST
Practice Address - Street 2:
Practice Address - City:GERING
Practice Address - State:NE
Practice Address - Zip Code:69341-2972
Practice Address - Country:US
Practice Address - Phone:308-641-5298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4979553973103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool