Bennett, Tracy Ann
Bennett, Tracy Ann is an individual health care provider with primary practice located at 2510 E Capitol Dr , Shorewood WI 53211-2136. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bennett, Tracy Ann can be contacted via phone (414) 975-8106.Contact Information
Primary practice address
2510 E Capitol Dr
Shorewood WI 53211-2136
Phone: (414) 975-8106
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 131056-121 | Wisconsin |
Profile Details
| NPI number | 1417629668 |
|---|---|
| LBN Legal business name | Bennett, Tracy Ann |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2021 |
| Last updated | May 2nd, 2025 - about last year |
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 | 1417629668 | NPPES |
| Wisconsin | MEDICAID | 1417629668 |
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