Individual ProviderAudrei LacyCounselorBehavioral Health & Social Service ProvidersPractice Address1317 Jackson, Las Vegas, NV 89106(702) 610-7600PECOS EnrollmentBased on the most recent information from CMS, provider Audrei Lacy 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 4 days ago.Profile DetailsProvider ID1427493667Provider TypeIndividualFull NameLacy, AudreiGenderFemaleSole ProprietorNoEnumeration Date5/1/2013Last Updated5/1/2013Contact InformationPractice LocationPractice Address1317 Jackson, Las Vegas, NV 89106Phone(702) 610-7600FaxUnlisted FaxMailing LocationMailing Address1317 Jackson Ave, Las Vegas, NV 89106-2854Phone(702) 610-7600FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense1400909996Nevada