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Organization
TRACEY MALESA-WHEATON, LCSW, LLC
Active
Organization
TRACEY MALESA-WHEATON, LCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY MALESA-WHEATON (OWNER)
(574) 520-4444
Entity
Organization
Contact information
Practice address
429 W LASALLE AVE APT 2, SOUTH BEND, IN 46601-1166
(574) 520-8444
(574) 367-2154
Mailing address
429 W LASALLE AVE APT 2, SOUTH BEND, IN 46601-1166
(574) 520-8444
(574) 367-2154
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
05/02/2023
Last updated
03/12/2024
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