Lara Jo Lackey is a Clinical in Portland, Oregon. Lara Jo Lackey practices all healthcare services and medical treatments related to Clinical. The NPI Number for Lara Jo Lackey is 1780875427. The last update date is 2007-08-07.
Lara Jo Lackey's current location address is 6403 N Villard Ave, Portland, Oregon. You can contact this provider via phone number 5037055265. The mailing address for Lara Jo Lackey is 6403 N Villard Ave, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Lara Jo Lackey |
|---|---|
| Address | 6403 N Villard Ave, Portland, Oregon |
| Phone Number | 5037055265 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.S.W. |
NPI Number Detail
| NPI Number | 1780875427 |
|---|---|
| Provider Enumeration Date | 2007-08-07 |
| Last Updated Date | 2007-08-07 |
Provider Mailing Address Detail
| Address | 6403 N Villard Ave |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972174046 |
| Phone Number | 5037055265 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | L3364 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique 10-digit identification code assigned to Lara Jo Lackey by the Centers for Medicare & Medicaid Services?
The Lara Jo Lackey has been issued the NPI (National Provider Identifier) 1780875427, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Lara Jo Lackey?
The Lara Jo Lackey is situated at 6403 N Villard Ave, in the city of Portland, state of OR, with the zip code 972174046.
What is Lara Jo Lackey's specialized field of practice, and what is the corresponding taxonomy classification code?
The Lara Jo Lackey's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 1041C0700X.
On what date did Lara Jo Lackey receive its 1780875427 assignment from the Centers for Medicare & Medicaid Services?
The Lara Jo Lackey was assigned its 1780875427 on 2007-08-07, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Lara Jo Lackey, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Lara Jo Lackey, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-08-07.