Provider Demographics
NPI:1194864546
Name:SZAKACS, TRACEY (LPC)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:SZAKACS
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 1:1152 COUNTY LINE RD APT 32
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66103-2339
Mailing Address - Country:US
Mailing Address - Phone:816-830-4514
Mailing Address - Fax:816-241-2797
Practice Address - Street 1:1152 COUNTY LINE RD APT 32
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66103-2339
Practice Address - Country:US
Practice Address - Phone:816-830-4514
Practice Address - Fax:816-241-2797
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005026034101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO490268703Medicaid