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Individual
MS. TRACY ELIZABETH PHILLIPS
Active
Individual
MS. TRACY ELIZABETH PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, ATR
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R055230-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00055230
—
NY
01
—
055230A37
HEALTH FIRST
NY
01
—
W22701
MAGELLEN
NY
Enumeration date
10/27/2006
Last updated
07/08/2007
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