Provider Demographics
NPI:1427263037
Name:LACY, PAMELA MAE (LCSW, MSW)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:MAE
Last Name:LACY
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BROOKFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5149
Mailing Address - Country:US
Mailing Address - Phone:973-768-2523
Mailing Address - Fax:973-656-9823
Practice Address - Street 1:24 ELM ST
Practice Address - Street 2:SUITE 3
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-8802
Practice Address - Country:US
Practice Address - Phone:973-768-2523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053056001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical