Individual
LACEY ROUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1075 E PARK BLVD, BOISE, ID 83712-7722
(208) 381-5970
(208) 381-5971
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-38291
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000001
ST OF WA
WA
Enumeration date
05/26/2015
Last updated
02/11/2026
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