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Kelli Beth Lacy, PRSS
Peer Specialist in Logan, West Virginia
NPI 1013643352

Kelli Beth Lacy is a Peer Specialist based in Logan, WV. Kelli Beth Lacy practices in Logan, WV and has the professional credentials of PRSS. The NPI Number for Kelli Beth Lacy is 1013643352 and holds a License No. 21-913 (West Virginia).

The current practice location address for Kelli Beth Lacy is 509 Main St, Logan, WV and can be reached out via phone at 304-896-5008. You can also correspond with Kelli Beth Lacy through the mailing address at 509 MAIN ST, LOGAN, WV - 25601-3809 (mailing address contact number: 304-896-5008).

Location: 509 Main St, Logan, WV, 25601-3809
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013643352
Provider Name
Kelli Beth Lacy
Credential
PRSS
Provider Entity Type
Individual
Gender
Female
Address
509 Main St, Logan, WV, 25601-3809
Phone Number
304-896-5008
Fax Number
Provider Enumeration Date
07/28/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
509 Main St
City
Logan
State
West Virginia
Zip
25601-3809
Phone Number
304-896-5008
Fax Number
person
Provider Business Mailing Address Details
Address
509 Main St
City
Logan
State
West Virginia
Zip
25601-3809
Phone Number
304-896-5008
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
21-913 (West Virginia)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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