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NPI Code Detail

MEDICARE: MS. TRACI J MARRERO MA, LPC, CPAS, CAMT

MEDICARE: MS. TRACI J MARRERO MA, LPC, CPAS, CAMT
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
1101YP2500XProfessional CounselorLPC016493GA

General Provider Information

NPI Number : 1881452209
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TRACI J MARRERO MA, LPC, CPAS, CAMT
Provider Business Mailing Address
First Line : 109 SHELBY RAE RD NE
Second Line :
City : LUDOWICI
State : GA
Zip : 31316-7584
Country : US
Telephone Number : 912-318-6201
Fax Number : 912-369-2262
Provider Business Practice Location Address
First Line : 101 E MEMORIAL DR
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-2727
Country : US
Telephone Number : 912-876-4010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2024
Last Update Date : 03/13/2026

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