Anderson, Tracie L
Anderson, Tracie L is an individual health care provider with primary practice located at 510 Spring St , Jeffersonville IN 47130-3554. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Anderson, Tracie L can be contacted via phone (812) 282-1888.Contact Information
Primary practice address
510 Spring St
Jeffersonville IN 47130-3554
Phone: (812) 282-1888
Fax: (812) 218-9318
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 34000315A | Indiana |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 807 | Kentucky |
Profile Details
| NPI number | 1407859465 |
|---|---|
| LBN Legal business name | Anderson, Tracie L |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2005 |
| Last updated | Aug 15th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407859465 | NPPES |
| Kentucky | Other | 2767013000 | PASSPORT ADVANTAGE |
| Kentucky | Other | 82900176 | PASSPORT ADVANTAGE |
| Kentucky | Other | 160780 | PASSPORT ADVANTAGE |
| Kentucky | Other | 000000056294 | PASSPORT ADVANTAGE |
| Kentucky | Other | 2444451000 | PASSPORT ADVANTAGE |
| Kentucky | Other | 160860 | PASSPORT ADVANTAGE |
| Kentucky | MEDICAID | 8200076100 | PASSPORT ADVANTAGE |
| Kentucky | Other | 000000226075 | PASSPORT ADVANTAGE |
| Kentucky | Other | 264003000 | PASSPORT ADVANTAGE |
| Kentucky | Other | 50704000 | PASSPORT ADVANTAGE |
| Kentucky | Other | CG3623 | PASSPORT ADVANTAGE |
| Kentucky | Other | 100386460 | PASSPORT ADVANTAGE |
| Kentucky | Other | 1518960681 | PASSPORT ADVANTAGE |
| Kentucky | Other | 800012510 | PASSPORT ADVANTAGE |
| Kentucky | Other | 78903689 | PASSPORT ADVANTAGE |
| Kentucky | Other | 94882000 | PASSPORT ADVANTAGE |
| Kentucky | MEDICAID | 200319860A | PASSPORT ADVANTAGE |
| Kentucky | Other | 65927857 | PASSPORT ADVANTAGE |
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