Healthcare Provider Details

I. General information

NPI: 1861858136
Provider Name (Legal Business Name): TRACYLYNN ESGUERRA NAVARRO LPC, ATR-BC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2016
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CORNERSTONE DR
LANGHORNE PA
19047-1314
US

IV. Provider business mailing address

871 W OAKLAND PARK BLVD
WILTON MANORS FL
33311-1731
US

V. Phone/Fax

Practice location:
  • Phone: 215-757-6916
  • Fax:
Mailing address:
  • Phone: 954-567-7141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH17103
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC007677
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: