Individual
LACEY J. EXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 AUDUBON PLAZA DR, LOUISVILLE, KY 40217-1318
(502) 636-8334
(502) 629-3132
Mailing address
PO BOX 776347, CHICAGO, IL 60677-6347
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
254023
KY
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
07/27/2010
Last updated
10/12/2020
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