MEDICARE: TRACI J FOLEY LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	S.1700319	OH

General Provider Information

NPI Number	:	1255217303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACI J FOLEY LSW

Provider Business Mailing Address
First Line	:	65 HIGH ST
Second Line	:
City	:	SEVILLE
State	:	OH
Zip	:	44273-9308
Country	:	US
Telephone Number	:	330-256-0399
Fax Number	:

Provider Business Practice Location Address
First Line	:	65 HIGH ST
Second Line	:
City	:	SEVILLE
State	:	OH
Zip	:	44273-9308
Country	:	US
Telephone Number	:	330-256-0399
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2025
Last Update Date	:	08/13/2025

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