MEDICARE: TRACEY LAZORE MSW

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	P116333	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P116333	OTHER	NY	LIMITED PERMIT

General Provider Information

NPI Number	:	1548996887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACEY LAZORE MSW

Provider Business Mailing Address
First Line	:	1759 NEWPORT RD
Second Line	:
City	:	POLAND
State	:	NY
Zip	:	13431-1708
Country	:	US
Telephone Number	:	315-867-3219
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 MAIN ST
Second Line	:
City	:	CAMDEN
State	:	NY
Zip	:	13316-1302
Country	:	US
Telephone Number	:	315-533-2570
Fax Number	:

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

Provider Enumeration Date	:	07/28/2022
Last Update Date	:	07/28/2022

Similar Medicare Providers

1497790521 — MICHELLE LYNN WILLIAMS
Practice Location Address:

20 MAIN ST
CAMDEN, NY
13316-1302

Practice Phone: 315-335-9727
Practice Fax:

1821638115 — SAMANTHA WALKER
Practice Location Address:

20 MAIN ST
CAMDEN, NY
13316-1302

Practice Phone: 315-533-2570
Practice Fax:

1093319576 — COME TO THE TABLE COUNSELING LCSW
Practice Location Address:

40 MAIN ST LOWR
CAMDEN, NY
13316-1302

Practice Phone: 315-335-9727
Practice Fax:

1154058196 — AMY OLIVIA REDMOND
Practice Location Address:

40 MAIN ST
CAMDEN, NY
13316-1302

Practice Phone: 315-533-2570
Practice Fax:

1730966151 — MRS. JULIE ANN NOTI LCSW
Practice Location Address:

20 MAIN ST
CAMDEN, NY
13316-1302

Practice Phone: 315-533-2570
Practice Fax:

1518827278 — BETHANY JOY GINGERICH
Practice Location Address:

20 MAIN ST
CAMDEN, NY
13316-1302

Practice Phone: 315-820-2638
Practice Fax: 315-820-2638

Directions to “ TRACEY LAZORE MSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.