Individual
LACEY T BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1222 JEFFERSON PARK AVE, CHARLOTTESVILLE, VA 22903-3410
(434) 924-1931
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
(434) 295-1000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904018140
VA
Other
Enumeration date
07/28/2025
Last updated
07/28/2025
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