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Individual

LACEY M MARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1302 7TH AVE, BEAVER FALLS, PA 15010-4217
(724) 843-0314
(724) 843-0316
Mailing address
100 SHENANGO AVE, SHARON, PA 16146-1503
(724) 843-0314
(724) 843-0316

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
SW130887
PA
1041C0700X
Clinical Social Worker
Primary
CW018950
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1030654040001
PA
Enumeration date
04/01/2015
Last updated
06/09/2017
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