Healthcare Provider Details

I. General information

NPI: 1831743095
Provider Name (Legal Business Name): TRACY LYNN CARRAGGI MSN, AGACNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TRACY LYNN CARRAGGI AGACNP-BC, PMHNP-BC

II. Dates (important events)

Enumeration Date: 07/26/2019
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CABOT BLVD STE 300
MANSFIELD MA
02048-1183
US

IV. Provider business mailing address

20 CABOT BLVD STE 300
MANSFIELD MA
02048-1183
US

V. Phone/Fax

Practice location:
  • Phone: 781-202-1565
  • Fax: 617-789-6741
Mailing address:
  • Phone: 781-202-1565
  • Fax: 617-789-6741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN240930
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN240930
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN05153
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: