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General NPI Number Information
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NPI Number | 1770221053
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Entity Type | Individual
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Provider Name | TRACY L BUGGLIN LPCC-S, LSW
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Gender | Female
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Dates
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Enumeration Date | 05/25/2022
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Last Update Date | 05/25/2022
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Provider Practice Location Address
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Address Line | 2500 JOHN GLENN HWY
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City | CAMBRIDGE
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State | OH
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Zip | 43725-9028
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Country | US
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Telephone | 740-439-4428
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Fax | 740-439-3389
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Provider Business Mailing Address
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Address Line | 2845 BELL ST
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City | ZANESVILLE
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State | OH
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Zip | 43701-1720
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Country | US
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Telephone | 740-454-9766
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Fax | 740-588-6452
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.0005807
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.0002168
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License Number State | OH
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