Individual
LACEY NICOLE TOLLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPSS, CSA
Contact information
Practice address
80 HIGHWAY 2227, SOMERSET, KY 42503-1562
(606) 485-4003
Mailing address
233 PARKERS MILL WAY, SOMERSET, KY 42503-4152
(606) 458-4450
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
KY
175T00000X
Peer Specialist
Primary
—
KY
Other
Enumeration date
02/06/2025
Last updated
10/08/2025
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