Individual
MRS. INGRID JENNIFER LACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, BC-DMT, GLCMA
Contact information
Practice address
1799 CLAIRMONT RD, DECATUR, GA 30033
(415) 913-8831
Mailing address
2156 CAVANAUGH AVE SE, ATLANTA, GA 30316-2706
(415) 913-8831
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC 206
CA
Other
Enumeration date
06/22/2013
Last updated
05/31/2018
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