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NPI Code Detail

MEDICARE: TRACY A. MAYER L.C.S.W.

MEDICARE:   TRACY A. MAYER  L.C.S.W.
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
11041C0700XClinical Social Worker7268123WI

General Provider Information

NPI Number : 1265579304
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY A. MAYER L.C.S.W.
Provider Business Mailing Address
First Line : PO BOX 1649
Second Line :
City : JANESVILLE
State : WI
Zip : 53547-1649
Country : US
Telephone Number : 608-757-5238
Fax Number :
Provider Business Practice Location Address
First Line : 3530 N. COUNTY TRUNK HIGHWAY F
Second Line :
City : JANESVILLE
State : WI
Zip : 53547-1649
Country : US
Telephone Number : 608-757-5238
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 07/08/2007

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Directions to “ TRACY A. MAYER L.C.S.W.” Practice Location

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