Provider Demographics
NPI:1225912041
Name:CONNORS, LACEY (MS, LCMHC-A)
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:
Last Name:CONNORS
Suffix:
Gender:F
Credentials:MS, LCMHC-A
Other - Prefix:
Other - First Name:LACEY
Other - Middle Name:
Other - Last Name:NICKELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2400 KING RICHARD CT APT G
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5469
Mailing Address - Country:US
Mailing Address - Phone:901-596-6280
Mailing Address - Fax:
Practice Address - Street 1:2400 KING RICHARD CT APT G
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5469
Practice Address - Country:US
Practice Address - Phone:901-596-6280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1282791101YS0200X
NCA21153101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool