Provider Demographics
NPI:1003283490
Name:RAMEY, TRACY (LCSW)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:RAMEY
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 1:30 ELIZABETH ST
Mailing Address - Street 2:LOWER NAUGATUCK VALLEY PARENT CHILD RESOURCE CENTER, IN
Mailing Address - City:DERBY
Mailing Address - State:CT
Mailing Address - Zip Code:06418-1802
Mailing Address - Country:US
Mailing Address - Phone:203-954-0543
Mailing Address - Fax:203-954-0544
Practice Address - Street 1:30 ELIZABETH ST
Practice Address - Street 2:30 ELIZABETH STREET
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418-1802
Practice Address - Country:US
Practice Address - Phone:203-954-0543
Practice Address - Fax:203-954-0544
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0087351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004039541Medicaid