Individual
CAROLYN LACEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
875 STATE ROUTE VV, KENNETT, MO 63857-9108
(573) 559-2380
Mailing address
875 STATE ROUTE VV, KENNETT, MO 63857-9108
(573) 559-2380
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/10/2023
Last updated
04/27/2026
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