Johnson, Tracey L

Johnson, Tracey L is an individual health care provider with primary practice located at 150 Oakland Ave , Rock Hill SC 29730-4073. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Johnson, Tracey L can be contacted via phone (803) 334-4056.

Contact Information

Primary practice address
150 Oakland Ave Rock Hill SC 29730-4073
Phone: (803) 334-4056
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 6970 South Carolina

Profile Details

NPI number 1396816385
LBN Legal business name Johnson, Tracey L
Credentials L.I.S.W.-CP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated Aug 14th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396816385 NPPES
South Carolina Other CJ5560 RAILROAD MEDICARE
South Carolina Other 570629234006 RAILROAD MEDICARE

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