MEDICARE: TRACEY STRACENER LCMHC-S

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	S8060	NC

General Provider Information

NPI Number	:	1942511639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACEY STRACENER LCMHC-S

Provider Business Mailing Address
First Line	:	11010 LAKE GROVE BLVD STE 100-232
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-7391
Country	:	US
Telephone Number	:	919-378-0366
Fax Number	:	980-412-7969

Provider Business Practice Location Address
First Line	:	11010 LAKE GROVE BLVD STE 100-232
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-7391
Country	:	US
Telephone Number	:	919-378-0366
Fax Number	:	980-412-7969

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

Provider Enumeration Date	:	06/28/2010
Last Update Date	:	06/08/2026

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