Healthcare Provider Details

I. General information

NPI: 1083137129
Provider Name (Legal Business Name): PATRICE VERNIQUE BARNES-TRACEY PHD, LCSW, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2017
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ECHO HL
DOBBS FERRY NY
10522-3600
US

IV. Provider business mailing address

164 MILTON AVE PH
WEST HAVEN CT
06516-6712
US

V. Phone/Fax

Practice location:
  • Phone: 914-693-0600
  • Fax:
Mailing address:
  • Phone: 718-757-6156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16036
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number099759
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0831371
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: