Provider Demographics
NPI:1548837180
Name:LACY, ASHLEY (LMFTA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:LACY
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9702 183RD STREET CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-6312
Mailing Address - Country:US
Mailing Address - Phone:253-904-6038
Mailing Address - Fax:253-409-2622
Practice Address - Street 1:9702 183RD STREET CT E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-6312
Practice Address - Country:US
Practice Address - Phone:253-904-6038
Practice Address - Fax:253-409-2622
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2024-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG61266227101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional