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General NPI Number Information
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NPI Number | 1437340742
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Entity Type | Individual
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Provider Name | CRAIG E LACY MS, LPC
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Gender | Male
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 08/05/2007
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Provider Practice Location Address
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Address Line | 1220 VALLEY FORGE ROAD BLDG B SUITE 2
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City | VALLEY FORGE
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State | PA
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Zip | 19480
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Country | US
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Telephone | 610-805-7720
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Fax | 610-933-8019
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Provider Business Mailing Address
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Address Line | 1200 W WASHINGTON ST
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City | NORRISTOWN
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State | PA
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Zip | 19401-4313
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Country | US
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Telephone | 610-805-7720
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Fax | 610-239-9085
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC001431
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License Number State | PA
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