| Doctor Name: | LACEY COLLEEN PICKETT |
| NPI Number: | 1003278334 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S, LPC-I |
| License Number: | 6321 |
| Business Practice Address: | 3969 Southeastern Way C West Columbia, SC - 291692442 |
| Business Phone Number: | 8037273882 |
| Business Fax Number: | 8037089263 |
| Mailing Address: | 3969 Southeastern Way, C WEST COLUMBIA |
| State: | SC |
| Postal Code: | 291692442 |
| Phone Number: | 8037273882 |
| Fax Number: | 8037089263 |
| NPI Enumeration Date: | 03/25/2016 |
| NPI Last Update Date: | 06/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6321 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |