MRS. LACEY JO WALLACE MS, PLPC
NPI 1710461868
Counselor - Mental Health in Springfield, MO
Active since September 24, 2018
About Mrs. Lacey Jo Wallace Ms, Plpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. LACEY JO WALLACE MS, PLPC (NPI 1710461868) is an individual mental health provider in Springfield, Missouri, licensed in Missouri (2017030034) and active in the NPI registry since September 2018.
NPPES Registry Identity
NPI1710461868
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMRS. LACEY JO WALLACECredential: MS, PLPC
Location Address2131 S EASTGATE AVESpringfield, MO 65809-2146
Mailing Address2131 S Eastgate AveSpringfield, MO 65809-2146 · (417) 763-3309
Phone(417) 763-3309
Sole ProprietorNo
Enumeration DateSeptember 24, 2018
✔ NPI 1710461868 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MO · 2017030034
2131 S EASTGATE AVE, Springfield, MO 65809
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710461868, enumerated as an "individual" on September 24, 2018.
The provider is located at 2131 S EASTGATE AVE SPRINGFIELD, MO 65809 and the phone number is (417) 763-3309.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
