Provider Demographics
NPI:1033889977
Name:HATZIS, TRACY LYN (LPC)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:LYN
Last Name:HATZIS
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 1:850 W BARTLETT RD STE 14C
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4454
Mailing Address - Country:US
Mailing Address - Phone:630-864-7267
Mailing Address - Fax:
Practice Address - Street 1:850 W BARTLETT RD STE 14C
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4454
Practice Address - Country:US
Practice Address - Phone:630-864-7267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.005706101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health