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General NPI Number Information
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NPI Number | 1154105112
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Entity Type | Organization
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Legal Business Name | LACEY TRENT LMSW LLC
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Dates
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Enumeration Date | 08/22/2023
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Last Update Date | 04/20/2025
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Provider Practice Location Address
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Address Line | 37400 GARFIELD RD STE 110
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City | CLINTON TWP
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State | MI
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Zip | 48036-3648
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Country | US
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Telephone | 562-652-9744
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Fax |
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Provider Business Mailing Address
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Address Line | 37400 GARFIELD RD STE 110
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48036-3648
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Country | US
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Telephone | 562-652-9744
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Fax |
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Authorized Official
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Title or Position | LMSW/THERAPIST
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Name | LACEY TRENT
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Credential | LMSW, LCSW
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Telephone | 562-652-9744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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