Provider Demographics
NPI:1679949713
Name:LACEY, MEGHAN (LPC)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:LACEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:SCHWEINHAGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2500 E ENTERPRISE AVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-8557
Mailing Address - Country:US
Mailing Address - Phone:920-416-8577
Mailing Address - Fax:920-416-8581
Practice Address - Street 1:2500 E ENTERPRISE AVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8557
Practice Address - Country:US
Practice Address - Phone:920-416-8577
Practice Address - Fax:920-416-8581
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009800101YM0800X
WI6616-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health