Healthcare Provider Details

I. General information

NPI: 1649597956
Provider Name (Legal Business Name): TRACY LYNN CHIARI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRACY LYNN FALWELL LCSW

II. Dates (important events)

Enumeration Date: 04/26/2010
Last Update Date: 10/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6823 CYPRESSWOOD DR
SPRING TX
77379-7705
US

IV. Provider business mailing address

7675 AMESWOOD RD
HOUSTON TX
77095-3301
US

V. Phone/Fax

Practice location:
  • Phone: 281-376-8006
  • Fax:
Mailing address:
  • Phone: 713-851-0959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number30845
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: