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General NPI Number Information
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NPI Number | 1447334495
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Entity Type | Individual
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Provider Name | TRACY LYNN KASPER-O'HEARNE LMHC
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 81 SAMOSET ST
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City | PLYMOUTH
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State | MA
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Zip | 02360-4500
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Country | US
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Telephone | 508-269-7877
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Fax | 508-591-8214
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Provider Business Mailing Address
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Address Line | 116 PRECINCT ST
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City | LAKEVILLE
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State | MA
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Zip | 02347-1425
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Country | US
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Telephone | 508-947-8305
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5160
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License Number State | MA
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