MEDICARE: LACY ELSMORE MSW, LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	16579	TN

General Provider Information

NPI Number	:	1285588996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LACY ELSMORE MSW, LMSW

Provider Business Mailing Address
First Line	:	1101 W 40TH ST UNIT 2225
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37409-1379
Country	:	US
Telephone Number	:	877-358-2998
Fax Number	:	423-405-6346

Provider Business Practice Location Address
First Line	:	7 N TUXEDO AVE
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37411-3728
Country	:	US
Telephone Number	:	877-358-2998
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2026
Last Update Date	:	02/21/2026

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