Lewis, Tracy Marie

Lewis, Tracy Marie is an sole proprietor health care provider with primary practice located at 925 Sullivan Ave Unit 2, South Windsor CT 06074-2025. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Lewis, Tracy Marie can be contacted via phone (860) 432-7771.

Contact Information

Primary practice address
925 Sullivan Ave Unit 2 South Windsor CT 06074-2025
Phone: (860) 432-7771
Fax: (860) 432-7774
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 0006994 Connecticut

Profile Details

NPI number 1093947657
LBN Legal business name Lewis, Tracy Marie
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 17th, 2009
Last updated Jul 1st, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093947657 NPPES
Connecticut MEDICAID 008013935

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