Provider Demographics
NPI:1720493398
Name:METCALF, TRACY (PHD, LCPC, NCC)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:
Last Name:METCALF
Suffix:
Gender:F
Credentials:PHD, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2364 ESSINGTON RD # 321
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-1664
Mailing Address - Country:US
Mailing Address - Phone:815-546-0897
Mailing Address - Fax:
Practice Address - Street 1:1000 S. HAMILTON ST.
Practice Address - Street 2:UNIT G
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441
Practice Address - Country:US
Practice Address - Phone:815-546-0897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.016123101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health