Provider Information for 1316686363
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Ms. ERICA NICOLE LACKEY LPC
Other Names:Former Name:Ms. ERICA NICOLE SCOTT LPCSex: Female
NPI: 1316686363
Last Updated: 2025-01-25
Certification Date: 2025-01-25
Certification Date: 2025-01-25
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1316686363 | ||||||||
| Enumeration Date | 2022-05-28 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 329 BLUE RIBBON RD WAXAHACHIE, TX 75165-8722 United States Phone: 972-268-4479 | Fax: | ||||||||
| Primary Practice Address | 4204 SW GREEN OAKS BLVD STE 120 ARLINGTON, TX 76017-4159 United States Phone: 682-422-9123 | Fax: | ||||||||
| Secondary Practice Address(es) | 329 BLUE RIBBON RD | ||||||||
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