Individual
LACEY HEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW, LGADC
Contact information
Practice address
4500 BLACK ROCK RD STE 103, HAMPSTEAD, MD 21074-2649
(877) 806-1501
Mailing address
12029 WARRENFELTZ LN, HAGERSTOWN, MD 21742-4498
(240) 356-7078
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
31583
MD
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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