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General NPI Number Information
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NPI Number | 1689601049
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Entity Type | Individual
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Provider Name | TRACY LYNN ZINANNI LCSW, ACSW, DCSW
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Gender | Female
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 07/09/2010
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Provider Practice Location Address
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Address Line | 3325 LUKE CROSSING DR
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City | CHARLOTTE
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State | NC
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Zip | 28226-3359
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Country | US
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Telephone | 704-900-6483
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Fax |
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Provider Business Mailing Address
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Address Line | 3325 LUKE CROSSING DR
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City | CHARLOTTE
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State | NC
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Zip | 28226-3359
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Country | US
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Telephone | 757-206-5970
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904006508
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C006324
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License Number State | NC
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