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General NPI Number Information
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NPI Number | 1760713739
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Entity Type | Individual
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Provider Name | TRACY ANN COFFEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/14/2010
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 11542 W 50 N
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City | WESTVILLE
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State | IN
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Zip | 46391-9515
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Country | US
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Telephone | 630-267-6794
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Fax |
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Provider Business Mailing Address
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Address Line | 11542 W 50 N
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City | WESTVILLE
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State | IN
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Zip | 46391-9515
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Country | US
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Telephone | 630-267-6794
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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 | 149014084
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License Number State | IL
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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 | 149.014084
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34011155A
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License Number State | IN
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