Individual
RICHARD HARVEY TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
215 MILKY WAY STREET SOUTH, COSMOS, MN 56228
(320) 877-7220
(320) 877-7479
Mailing address
215 MILKY WAY STREET SOUTH, COSMOS, MN 56228
(320) 877-7220
(320) 877-7479
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8638
MN
101YP2500X
Professional Counselor
8638
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274557000
—
MN
Enumeration date
08/20/2008
Last updated
08/20/2008
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