Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Justin David Lackey, OTD, OTR/L

Individual provider Pediatric Occupational Therapist · NPI 1477387835

Justin David Lackey, OTD, OTR/L is a Pediatric Occupational Therapist in Phoenix, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2024
What do these letters mean?
OTD — Doctor of Occupational Therapy
The doctoral degree in occupational therapy.
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

2120 E Park View Ln
Phoenix, AZ 85024-5302
Phone: (805) 338-3361
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Occupational Therapist (primary) Taxonomy 225XP0200X · Licence 009730 (AZ)

Record details

NPI number1477387835
Entity typeIndividual (Type 1)
GenderMale
Credentials OTD , OTR/L
Sole proprietorYes
NPI enumeratedAugust 28, 2024
Last updated in NPPESAugust 28, 2024
Certification dateAugust 28, 2024

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