REBECCA SUZANNE LACY (NPI# 1073079083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073079083 |
| Entity Type | Individual |
| Full Name | REBECCA SUZANNE LACY |
| Practice Address |
2409 Se 139th Ave Portland OR 97233-2041 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504-4004 |
| Practice Telephone | 5037863830 |
| Practice Fax Number | 5036533534 |
| Mailing Telephone | 5418588170 |
| Mailing Fax Number | 5418588167 |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2019-02-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
2409 SE 139TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97233-2041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144641150 | Amien James Griffin | Counselor | 2409 Se 139th Ave, Portland, OR 97233-2041 | 2013-12-17 |
| 1174905434 | Anita Bain | Counselor | 2409 Se 139th Ave, Portland, OR 97233-2041 | 2015-06-23 |
| 1992182968 | Anastasiya Morozova | Counselor | 2409 Se 139th Ave, Portland, OR 97233-2041 | 2015-04-29 |
| 1730577701 | Christina Morgan | Social Worker | 2409 Se 139th Ave, Portland, OR 97233-2041 | 2014-12-29 |
| 1578969077 | Paul Ajak | Counselor | 2409 Se 139th Ave, Portland, OR 97233-2041 | 2014-11-10 |
| 1639586993 | Bradley Zenger | Counselor | 2409 Se 139th Ave, Portland, OR 97233-2041 | 2014-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448164 | Moore Therapy Services, LLC | Behavioral Analyst | 2053 Se 181st Ave, Portland, OR 97233 | 2020-08-20 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1427573443 | Sunshine Ahc | In Home Supportive Care | 2217 Se 156th Ave, Portland, OR 97233 | 2017-08-10 |
| 1538609433 | Nathaniel Davis Jr. | Counselor | 8915 Se Center St, Tigard, OR 97233 | 2017-02-27 |
| 1154878627 | Oregon Outreach Inc | Case Management | 1740 South East 139th Avenue, Portland, OR 97233 | 2016-09-01 |
| 1023461019 | Julianne Baltzley | Counselor | 2409 Se 149th Avenue, Portland, OR 97233 | 2016-07-14 |
| 1710332143 | Emma Slater | Counselor | 12360 Se Burnside, Portland, OR 97233 | 2016-05-04 |
| 1245621952 | Gregory Brett Bledsoe | Counselor | 1427 Se 182nd Ave., Portland, OR 97233 | 2015-02-17 |
| 1396149852 | Jacqueline Bension | Counselor | 1705 Se 122nd Ave, Portland, OR 97233 | 2014-10-13 |
| 1700206950 | Olga I Zlatova I | Dental Hygienist | 325 Se 154th Ave, Portland, OR 97233 | 2014-04-25 |
| Find all providers in zip 97233 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748243 | Jessica M Feinsmith | Counselor | 6530 N Williams Ave, Portland, OR 97217-1924 | 2020-10-21 |
| 1720687809 | Karissa Myriah Gregory | Counselor | 14255 Se Rupert Dr, Portland, OR 97267-1211 | 2020-10-20 |
| 1528667904 | Zuzana Sakova | Counselor | 819 Se Morrison St Ste 225, Portland, OR 97214-6311 | 2020-10-18 |
| 1891302238 | Nina Landey | Counselor | 120 Se 53rd Ave, Portland, OR 97215-1204 | 2020-09-29 |
| 1902412166 | Peter H Addy LLC | Counselor | 524 N Tillamook St Ste 102b, Portland, OR 97227-1993 | 2020-09-22 |
| 1326654765 | Naomi Painter | Counselor | 1925 Ne 19th Ave Apt 8a, Portland, OR 97212-4526 | 2020-09-21 |
| 1750996104 | Sara Fuller | Counselor | 3016 Ne 70th Ave, Portland, OR 97213-5802 | 2020-09-12 |
| 1114532983 | Matthew W Cronin | Counselor | 1122 Ne 122nd Ave Ste 200, Portland, OR 97230-2081 | 2020-09-09 |
| 1447865381 | Luke Colbourn | Counselor | 2705 E Burnside St Ste 206, Portland, OR 97214-1768 | 2020-09-08 |
| 1710599774 | Abigail Kathryn Ernst | Counselor | 1020 Sw Taylor St # 100, Portland, OR 97205-2543 | 2020-08-20 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.