Individual
TRACI L. PENROD-MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LIMHP
Contact information
Practice address
820 S 75TH ST, OMAHA, NE 68114-4623
(402) 391-2477
(402) 397-4268
Mailing address
820 S 75TH ST, OMAHA, NE 68114-4623
(402) 391-2477
(402) 397-4268
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1110 1327 3557
NE
Other
Enumeration date
03/23/2007
Last updated
02/10/2016
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