Individual
JOHN ROBERT TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LISW
Contact information
Practice address
500 WILLOW AVE STE 210, COUNCIL BLUFFS, IA 51503-0827
(712) 332-4640
(712) 322-4643
Mailing address
500 WILLOW AVE STE 210, COUNCIL BLUFFS, IA 51503-0827
(712) 332-4640
(712) 322-4643
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1211
IA
1041C0700X
Clinical Social Worker
CSW.00991938
CO
Other
Enumeration date
07/11/2014
Last updated
07/19/2019
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