Mickelson, Tracy

Mickelson, Tracy is an individual health care provider with primary practice located at 1149 Sullivan St Ste B , Elmira NY 14901-1670. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Mickelson, Tracy can be contacted via phone (607) 733-7661.

Contact Information

Primary practice address
1149 Sullivan St Ste B Elmira NY 14901-1670
Phone: (607) 733-7661
Fax: (607) 733-7675
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X New York

Profile Details

NPI number 1639785033
LBN Legal business name Mickelson, Tracy
Credentials CASAC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2020
Last updated Sep 21st, 2020 - about 6 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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