Organization
MARY LUCAS LACEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY LUCAS LACEY M.S., DBH (COUNSELOR)
(704) 421-5505
Entity
Organization
Contact information
Practice address
3420 PLANTATION RD, CHARLOTTE, NC 28270-0729
(704) 421-5505
Mailing address
3420 PLANTATION RD, CHARLOTTE, NC 28270-0729
(704) 421-5505
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC3459
NC
Other
Enumeration date
12/03/2014
Last updated
12/03/2014
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