Individual
BRANDON LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
PO BOX 11531, CHARLOTTE, NC 28220-1531
(704) 301-2480
Mailing address
PO BOX 11531, CHARLOTTE, NC 28220-1531
(704) 301-2480
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P021954
NC
Other
Enumeration date
06/17/2025
Last updated
06/17/2025
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