Individual
LACY RENAE BANGERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0017704
CO
101YP2500X
Professional Counselor
Primary
1675
WY
101YP2500X
Professional Counselor
23036
AZ
101YP2500X
Professional Counselor
C8769
OR
Other
Enumeration date
03/03/2020
Last updated
06/05/2026
Update your record
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