Most Relevant Information
Provider Data
| NPI Number: | 1003278334 |
| Provider Name: | LACEY COLLEEN PICKETT M.S, LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 6321 |
Most Important Dates
| Enumeration Date: | 03/25/2016 |
| Last Updated: | 09/02/2020 |
Provider Practice Location
540 W MAIN ST
WYTHEVILLE
VA
243822209
Practice Location Phone/Fax
| Phone: | 2762233291 |
| Fax: | 2762233249 |
Provider Mailing Location
770 W RIDGE RD
WYTHEVILLE
VA
243821187
Provider Mailing Phone/Fax
| Phone: | 2762233200 |
| Fax: | 2762230617 |