Provider Demographics
NPI:1992464721
Name:LOVELACE, TRACY (LPC)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:LOVELACE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-3620
Mailing Address - Country:US
Mailing Address - Phone:484-510-0009
Mailing Address - Fax:
Practice Address - Street 1:2132 S 12TH ST STE 402
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-4810
Practice Address - Country:US
Practice Address - Phone:484-350-3001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011834101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional