MEDICARE: ERICA TRACEY LCSW

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	1041C0700X	Clinical Social Worker	092471	NY

General Provider Information

NPI Number	:	1275019374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA TRACEY LCSW

Provider Business Mailing Address
First Line	:	3240 HENRY HUDSON PKWY APT 3H
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-3220
Country	:	US
Telephone Number	:	914-517-2775
Fax Number	:

Provider Business Practice Location Address
First Line	:	3240 HENRY HUDSON PKWY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-3212
Country	:	US
Telephone Number	:	914-517-2775
Fax Number	:

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

Provider Enumeration Date	:	07/12/2018
Last Update Date	:	05/28/2026

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