MEDICARE: TRACY L CLARKE LPC

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	101YP2500X	Professional Counselor	PC013396	PA

General Provider Information

NPI Number	:	1780350926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY L CLARKE LPC

Provider Business Mailing Address
First Line	:	107 KNOX ST
Second Line	:
City	:	BRIDGEVILLE
State	:	PA
Zip	:	15017-3017
Country	:	US
Telephone Number	:	412-726-2140
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 ROESSLER RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15220-1037
Country	:	US
Telephone Number	:	412-344-3640
Fax Number	:

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

Provider Enumeration Date	:	08/18/2021
Last Update Date	:	05/07/2026

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Directions to “ TRACY L CLARKE LPC” Practice Location

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