Provider Demographics
NPI:1386411874
Name:TIMPONE, LACY JOY (LPC)
Entity type:Individual
Prefix:
First Name:LACY
Middle Name:JOY
Last Name:TIMPONE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CUERO
Mailing Address - State:TX
Mailing Address - Zip Code:77954-2544
Mailing Address - Country:US
Mailing Address - Phone:361-243-8819
Mailing Address - Fax:
Practice Address - Street 1:406 2ND ST
Practice Address - Street 2:
Practice Address - City:CUERO
Practice Address - State:TX
Practice Address - Zip Code:77954-2544
Practice Address - Country:US
Practice Address - Phone:361-243-8819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85270101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional