Provider Demographics
NPI:1699935874
Name:BOCCI, TRACY SANNER (LCSW)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:SANNER
Last Name:BOCCI
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 1:14393 W BAYAUD PL
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5339
Mailing Address - Country:US
Mailing Address - Phone:303-279-3116
Mailing Address - Fax:
Practice Address - Street 1:11500 W 20TH AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-1224
Practice Address - Country:US
Practice Address - Phone:303-237-1150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9928681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical