Healthcare Provider Details

I. General information

NPI: 1457288193
Provider Name (Legal Business Name): TRACY L HILL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154.5 MAIN ST
INDIAN ORCHARD MA
01151
US

IV. Provider business mailing address

145 DEVENS ST
INDIAN ORCHARD MA
01151-2305
US

V. Phone/Fax

Practice location:
  • Phone: 413-301-8170
  • Fax:
Mailing address:
  • Phone: 413-388-9836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: