Provider Demographics
NPI:1043443831
Name:TRACY, JOSHUA (LMFT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:TRACY
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-2001
Mailing Address - Country:US
Mailing Address - Phone:781-825-7505
Mailing Address - Fax:
Practice Address - Street 1:3 COUNTY RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-2001
Practice Address - Country:US
Practice Address - Phone:781-825-7505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC60089316101YM0800X
MA000001677106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health