MEDICARE: MS. TRACY K. WEBB 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	LPC 3648	SC

General Provider Information

NPI Number	:	1891847042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TRACY K. WEBB LPC

Provider Business Mailing Address
First Line	:	3327 BLOSSOM ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29205-2730
Country	:	US
Telephone Number	:	803-318-1417
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 MONCKTON BLVD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29206-4710
Country	:	US
Telephone Number	:	803-881-9810
Fax Number	:

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	10/21/2021

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