Provider Demographics
NPI:1851252324
Name:WORTHY, TRACY LENORE
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:LENORE
Last Name:WORTHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22720 WEST ST APT B
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-2202
Mailing Address - Country:US
Mailing Address - Phone:225-455-9251
Mailing Address - Fax:
Practice Address - Street 1:6619 LINDALE MANOR CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-8930
Practice Address - Country:US
Practice Address - Phone:281-723-4375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-22
Last Update Date:2025-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty