MEDICARE: MS. TRACY LYNN FARVER

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
1	104100000X	Social Worker
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1881906923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TRACY LYNN FARVER

Provider Business Mailing Address
First Line	:	755 PHEASANT GROVE AVE NW
Second Line	:
City	:	MASSILLON
State	:	OH
Zip	:	44646-3083
Country	:	US
Telephone Number	:	740-804-1403
Fax Number	:

Provider Business Practice Location Address
First Line	:	755 PHEASANT GROVE AVE NW
Second Line	:
City	:	MASSILLON
State	:	OH
Zip	:	44646-3083
Country	:	US
Telephone Number	:	740-804-1403
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2010
Last Update Date	:	02/09/2026

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