Provider Demographics
NPI:1588778799
Name:JAMES, LACI D (MS,LPC,LCDC,LSW,)
Entity type:Individual
Prefix:
First Name:LACI
Middle Name:D
Last Name:JAMES
Suffix:
Gender:F
Credentials:MS,LPC,LCDC,LSW,
Other - Prefix:
Other - First Name:LACI
Other - Middle Name:D
Other - Last Name:JAMES-NISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,LPC,LCDC,LSW,
Mailing Address - Street 1:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:MEXIA
Mailing Address - State:TX
Mailing Address - Zip Code:76667-0174
Mailing Address - Country:US
Mailing Address - Phone:254-562-9185
Mailing Address - Fax:254-562-7174
Practice Address - Street 1:824A N HIGHWAY 171
Practice Address - Street 2:
Practice Address - City:MEXIA
Practice Address - State:TX
Practice Address - Zip Code:76667-2051
Practice Address - Country:US
Practice Address - Phone:254-562-9185
Practice Address - Fax:254-562-7174
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6604101YA0400X
TX13050101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3014LCOtherBLUECROSSBLUE SHIELD
TX6604OtherLICENSED CD COUNSELOR
TX13050OtherLIC. PROF. COUNSELOR
TX22725OtherLICENSED SOCIAL WORKER