LACEY VAN DEN HAM
NPI 1912495227
Counselor - Mental Health in Marina, CA
Active since April 23, 2018
About Lacey Van Den Ham NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LACEY VAN DEN HAM (NPI 1912495227) is an individual mental health provider in Marina, California and active in the NPI registry since April 2018.
NPPES Registry Identity
NPI1912495227
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameLACEY VAN DEN HAM
Location Address617 BAYONET CIRMarina, CA 93933-4600
Mailing Address617 Bayonet CirMarina, CA 93933-4600
Phone(831) 384-7251
Sole ProprietorNo
Enumeration DateApril 23, 2018
✔ NPI 1912495227 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
617 BAYONET CIR, Marina, CA 93933
Other Names 1
Former Name (1)Lacey Smith
Other Providers at the Same Location NPPES 19
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 1912495227, enumerated as an "individual" on April 23, 2018.
The provider is located at 617 BAYONET CIR MARINA, CA 93933 and the phone number is (831) 384-7251.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
