LACEY VAN DEN HAM (NPI# 1912495227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912495227 |
| Entity Type | Individual |
| Full Name | LACEY VAN DEN HAM |
| Other Name | LACEY SMITH |
| Practice Address |
617 Bayonet Cir Marina CA 93933-4600 |
| Practice Telephone | 8313847251 |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-04-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
617 BAYONET CIR |
| City | MARINA |
| State | CA |
| Zip Code | 93933-4600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316184369 | David Ray Smith | Counselor | 617 Bayonet Cir, Marina, CA 93933-4600 | 2009-01-13 |
| 1366059685 | Cynthia Merrie Lopez | Counselor | 617 Bayonet Cir, Marina, CA 93933-4600 | 2020-09-30 |
| 1689293045 | Janet Baggett | Registered Nurse | 617 Bayonet Cir, Marina, CA 93933-4600 | 2020-04-15 |
| 1710527700 | Xochitl Guerrero | Counselor | 617 Bayonet Cir, Marina, CA 93933-4600 | 2020-01-08 |
| 1932749009 | Marylou Hernandez | Counselor | 617 Bayonet Cir, Marina, CA 93933-4600 | 2020-01-07 |
| 1861037939 | Lissette Gomez | Counselor | 617 Bayonet Cir, Marina, CA 93933-4600 | 2019-11-13 |
| 1215578182 | David Petrini | Counselor | 617 Bayonet Cir, Marina, CA 93933-4600 | 2019-10-02 |
| 1376194886 | Guadalupe Martinez | Counselor | 617 Bayonet Cir, Marina, CA 93933-4600 | 2019-09-25 |
| 1124676069 | Karina Ramires | Counselor | 617 Bayonet Cir, Marina, CA 93933-4600 | 2019-09-03 |
| 1386299014 | Shivani Prasanna Dongre | Counselor | 617 Bayonet Cir, Marina, CA 93933-4600 | 2019-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841803012 | Caterina Poehner | Social Worker | 617 Bayonet Cirle, Marina, CA 93933 | 2020-08-28 |
| 1972036499 | Stephanie Blalock | Counselor | 617 Bayonet Circle, Marina, CA 93933 | 2017-04-11 |
| 1588110340 | Monique Theaker | Counselor | 299b Twelfth Street, Marina, CA 93933 | 2016-08-31 |
| 1053709220 | Mehry Khazan | Marriage & Family Therapist | 299 Twelfth Street, Marina, CA 93933 | 2014-12-22 |
| 1306241476 | Tiffany Avery | Counselor | 299 12th St Ste B, Marina, CA 93933 | 2014-10-30 |
| 1881037141 | Marilyn Anderson | Counselor | 3043 Macarthur Dr, Marina, CA 93933 | 2013-04-16 |
| 1669744280 | Leslie Penley | Dentist | 3154 Deforest Rd. Suitea, Marina, CA 93933 | 2012-01-27 |
| 1215221510 | Janet Hernandez Barajas | Social Worker | 299a 12th Street, Marina, CA 93933 | 2011-06-03 |
| 1538302740 | Sonia Cortes | Counselor | 613 Bayonet Cir., Marina, CA 93933 | 2009-04-17 |
| 1144476003 | Carolina Cortez | Counselor | 2982 Bayonet Ct, Marina, CA 93933 | 2008-08-12 |
| Find all providers in zip 93933 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669018081 | Dennica Marie Domingo Paguio | Counselor | 3039 Marina Dr Unit 15, Marina, CA 93933-2955 | 2019-11-20 |
| 1194217141 | Maria Martinez-navarro | Counselor | 3016 Lexington Ct, Marina, CA 93933-4735 | 2018-06-05 |
| 1972036499 | Stephanie Blalock | Counselor | 617 Bayonet Circle, Marina, CA 93933 | 2017-04-11 |
| 1063870343 | Jennifer Edwards | Counselor | 3104 Bayer St, Apartment 13, Marina, CA 93933-3403 | 2016-02-02 |
| 1306241476 | Tiffany Avery | Counselor | 299 12th St Ste B, Marina, CA 93933 | 2014-10-30 |
| 1144476003 | Carolina Cortez | Counselor | 2982 Bayonet Ct, Marina, CA 93933 | 2008-08-12 |
| 1366059685 | Cynthia Merrie Lopez | Counselor | 617 Bayonet Cir, Marina, CA 93933-4600 | 2020-09-30 |
| 1528682820 | Ian Olden | Counselor | 299 12th St Ste B, Marina, CA 93933-6003 | 2020-06-02 |
| 1346875457 | Andrew Louis Cole Candreva | Counselor | 601 Bayonet Cir, Marina, CA 93933-4600 | 2020-03-09 |
| 1407481872 | Matthew D Ferry | Counselor | 601 Bayonet Cir, Marina, CA 93933-4600 | 2020-03-06 |
| Find all providers in MARINA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.