MRS. LACEY JANE BUCKELEW ASW
NPI 1417624859
Social Worker in Costa Mesa, CA

Q: What is Lacey Buckelew's NPI number?

The NPI number for Lacey Buckelew is 1417624859. It was assigned to this individual provider in the NPPES registry on August 24, 2021.

Q: What is Lacey Buckelew's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Lacey Buckelew was last updated on July 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 24, 2021PECOS Enrolled

301 VICTORIA ST, COSTA MESA, CA 92627(949) 574-3367(949) 999-6192 Get Directions Write a Review

NPPES record last updated: July 24, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 15, 2022, Aug 24, 2021 (2 updates tracked since 2021).

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About Mrs. Lacey Jane Buckelew Asw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. LACEY JANE BUCKELEW ASW (NPI 1417624859) is an individual social worker in Costa Mesa, California, licensed in California (124851) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417624859

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameMRS. LACEY JANE BUCKELEWCredential: ASW

Location Address301 VICTORIA STCosta Mesa, CA 92627-1995

Mailing AddressPo Box 735, 1927 Harbor Blvd.Costa Mesa, CA 92627 · (714) 651-1869

Phone(949) 574-3367

Fax(949) 999-6192

Sole ProprietorYes

Enumeration DateAugust 24, 2021

Last NPPES UpdateJuly 24, 20252 updates tracked since enumeration

NPPES CertifiedJuly 24, 2025

✔ NPI 1417624859 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

License✔ Licensed in CA · 124851

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

301 VICTORIA ST, Costa Mesa, CA 92627

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Lacey Jane Buckelew Asw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUMMER MARIE DEL REAL PMHNP

Nurse Practitioner (Psychiatric/Mental Health)