Provider Demographics
NPI:1427653633
Name:TRACY, HANNAH (LCSW)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:TRACY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6890 S 2300 E UNIT 712261
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84171-6087
Mailing Address - Country:US
Mailing Address - Phone:385-743-0545
Mailing Address - Fax:
Practice Address - Street 1:6890 S 2300 E UNIT 712261
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84171-6087
Practice Address - Country:US
Practice Address - Phone:385-743-0545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical