IndividualActive
Phyllis Lackey, LIC PROF COUNSELOR
NPI 1174682504 · Counselor · Xenia, OH
Phyllis Lackey, LIC PROF COUNSELOR is a Counselor provider in Xenia, OH (NPI 1174682504).
Provider details
- NPI number
- 1174682504
- Entity type
- Individual
- Primary specialty
- CounselorBehavioral Health & Social Service Providers
- Credential
- LIC PROF COUNSELOR
- Sex
- Female
- Sole proprietor
- No
- License
- C0003153 (OH)
Practice location
482 N Detroit St
Xenia, OH 45385
Phone: (937) 374-6010
Fax: (937) 374-6014
Street-level locationGet directions
Mailing address
76 Fordway Dr
Vandalia, OH 45377
Registry dates
- Enumerated
- 2006-12-08
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.