Provider Demographics
NPI:1154105112
Name:LACEY TRENT LMSW LLC
Entity type:Organization
Organization Name:LACEY TRENT LMSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMSW/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRENT
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, LCSW
Authorized Official - Phone:562-652-9744
Mailing Address - Street 1:37400 GARFIELD RD STE 110
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-3648
Mailing Address - Country:US
Mailing Address - Phone:562-652-9744
Mailing Address - Fax:
Practice Address - Street 1:37400 GARFIELD RD STE 110
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036-3648
Practice Address - Country:US
Practice Address - Phone:562-652-9744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-22
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty