Provider Demographics
NPI:1659721603
Name:KOESTER, LACEY (LSCSW, LCSW, RPT)
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:
Last Name:KOESTER
Suffix:
Gender:F
Credentials:LSCSW, LCSW, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1137 NEW YORK ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-3359
Mailing Address - Country:US
Mailing Address - Phone:785-218-9506
Mailing Address - Fax:
Practice Address - Street 1:1137 NEW YORK ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-3359
Practice Address - Country:US
Practice Address - Phone:785-218-9506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20220269321041C0700X
KS057001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical