Provider Demographics
NPI:1205228806
Name:HUSELTON, TRACY (LPC)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:HUSELTON
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 1:365 FRANKLIN HILL RD
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-8921
Mailing Address - Country:US
Mailing Address - Phone:724-543-1888
Mailing Address - Fax:724-543-1898
Practice Address - Street 1:200 RENAISSANCE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-7612
Practice Address - Country:US
Practice Address - Phone:724-287-1880
Practice Address - Fax:724-282-1848
Is Sole Proprietor?:No
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008001101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional