Individual ProviderAudra K LaceyMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address5480 Baltimore Dr Ste 103, La Mesa, CA 91942-2068(619) 559-8591PECOS EnrollmentBased on the most recent information from CMS, provider Audra K Lacey does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1215061254Provider TypeIndividualFull NameLacey, Audra KCredentialMFTGenderFemaleSole ProprietorYesEnumeration Date3/14/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address5480 Baltimore Dr Ste 103, La Mesa, CA 91942-2068Phone(619) 559-8591Fax(619) 271-7356Mailing LocationMailing Address5480 Baltimore Dr Ste 103, La Mesa, CA 91942-2068Phone(619) 559-8591Fax(619) 271-7356Provider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseMFC38530California