Individual
ETHAN KENT LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 LONG LAKE RD STE 320, NEW BRIGHTON, MN 55112-6439
(651) 482-9361
(651) 482-9888
Mailing address
900 LONG LAKE RD STE 320, NEW BRIGHTON, MN 55112-6439
(651) 482-9361
(651) 482-9888
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5193
MN
Other
Enumeration date
11/11/2022
Last updated
09/09/2025
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