Healthcare Provider Details

I. General information

NPI: 1245975945
Provider Name (Legal Business Name): TRACY VO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2022
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 FIELD ST
NEW BEDFORD MA
02740-2133
US

IV. Provider business mailing address

226 FIELD ST
NEW BEDFORD MA
02740-2133
US

V. Phone/Fax

Practice location:
  • Phone: 508-979-5557
  • Fax: 508-979-5955
Mailing address:
  • Phone: 508-979-5557
  • Fax: 508-979-5955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number227905
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: