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NPI Code Detail

MEDICARE: TRACY HOOPER LPC

MEDICARE:   TRACY  HOOPER  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLPC004648GA

General Provider Information

NPI Number : 1205999661
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY HOOPER LPC
Provider Business Mailing Address
First Line : 1401 BURLEYSON DR
Second Line :
City : DALTON
State : GA
Zip : 30720-2522
Country : US
Telephone Number : 706-270-5002
Fax Number : 706-270-5111
Provider Business Practice Location Address
First Line : 18090 HIGHWAY 515 N
Second Line : 18090 HWY 515 NORTH
City : ELLIJAY
State : GA
Zip : 30536-1331
Country : US
Telephone Number : 706-276-2024
Fax Number : 706-276-1502
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2006
Last Update Date : 07/08/2007

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Directions to “ TRACY HOOPER LPC” Practice Location

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