Individual
RICHARD LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LISW-CP, LAC, CACII
Contact information
Practice address
763 MEETING ST, CHARLESTON, SC 29403-3146
(412) 508-8275
Mailing address
45 SYCAMORE AVE APT 737, CHARLESTON, SC 29407-6726
(412) 508-8275
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
11391
SC
Other
Enumeration date
05/21/2015
Last updated
11/02/2019
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