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NPI Code Detail

MEDICARE: MS. TRACY G PERKINS LCSW

MEDICARE: MS. TRACY G PERKINS 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
11041C0700XClinical Social Worker3357KY

General Provider Information

NPI Number : 1932537644
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TRACY G PERKINS LCSW
Provider Business Mailing Address
First Line : 1662 PINTAIL DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40511-1388
Country : US
Telephone Number : 859-255-6645
Fax Number :
Provider Business Practice Location Address
First Line : 2250 THUNDERSTICK DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40505-9010
Country : US
Telephone Number : 859-227-1980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2013
Last Update Date : 07/21/2022

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