Healthcare Provider Details

I. General information

NPI: 1326972381
Provider Name (Legal Business Name): LACEY ROTHFUSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7406 CHAPEL HILL RD
RALEIGH NC
27607-5077
US

IV. Provider business mailing address

117 MCDOWELL LN
MEBANE NC
27302-0700
US

V. Phone/Fax

Practice location:
  • Phone: 919-590-0240
  • Fax: 919-573-0438
Mailing address:
  • Phone: 252-916-1639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberA23031
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: