Healthcare Provider Details

I. General information

NPI: 1548361751
Provider Name (Legal Business Name): LACEY SPEIGHT ALFORD PH.D., LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3595 REVERE RD SW
ATLANTA GA
30331-2340
US

IV. Provider business mailing address

3595 REVERE RD SW
ATLANTA GA
30331-2340
US

V. Phone/Fax

Practice location:
  • Phone: 404-344-5946
  • Fax: 404-344-9920
Mailing address:
  • Phone: 404-344-5946
  • Fax: 404-344-9920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC000245
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: