Provider Demographics
NPI:1225883234
Name:LACEY, PRECIOUS (LSW)
Entity type:Individual
Prefix:
First Name:PRECIOUS
Middle Name:
Last Name:LACEY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3057 CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5030
Mailing Address - Country:US
Mailing Address - Phone:310-703-4218
Mailing Address - Fax:
Practice Address - Street 1:3505 PERRYSVILLE AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15214-2212
Practice Address - Country:US
Practice Address - Phone:866-476-1199
Practice Address - Fax:866-477-9988
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW141424104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker