Healthcare Provider Details

I. General information

NPI: 1578643433
Provider Name (Legal Business Name): TRACI MICHELLE HART M.A., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TRACI MICHELLE DAVIS M.A., LPC

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 E PRENTICE AVE STE 300
GREENWOOD VILLAGE CO
80111-2906
US

IV. Provider business mailing address

8301 E PRENTICE AVE STE 300
GREENWOOD VILLAGE CO
80111-2906
US

V. Phone/Fax

Practice location:
  • Phone: 720-489-8555
  • Fax: 720-489-8304
Mailing address:
  • Phone: 720-489-8555
  • Fax: 720-489-8304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5111
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: