Healthcare Provider Details

I. General information

NPI: 1194851139
Provider Name (Legal Business Name): TRACY LEIGH ZAPARANICK PHD, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 GRADE LN
LOUISVILLE KY
40213
US

IV. Provider business mailing address

1101 GRADE LN
LOUISVILLE KY
40213-2673
US

V. Phone/Fax

Practice location:
  • Phone: 502-413-3882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number256241
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLSW0000004324
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: