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General NPI Number Information
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NPI Number | 1699935874
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Entity Type | Individual
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Provider Name | TRACY SANNER BOCCI LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 11500 W 20TH AVE
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City | LAKEWOOD
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State | CO
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Zip | 80215-1224
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Country | US
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Telephone | 303-237-1150
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Fax |
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Provider Business Mailing Address
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Address Line | 14393 W BAYAUD PL
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City | GOLDEN
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State | CO
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Zip | 80401-5339
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Country | US
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Telephone | 303-279-3116
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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 | 992868
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License Number State | CO
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