Provider Demographics
NPI:1225308935
Name:LEGATT, TRACANNE (PHD, LPCC, LADC)
Entity Type:Individual
Prefix:
First Name:TRACANNE
Middle Name:
Last Name:LEGATT
Suffix:
Gender:F
Credentials:PHD, LPCC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 135TH ST NE
Mailing Address - Street 2:
Mailing Address - City:RICE
Mailing Address - State:MN
Mailing Address - Zip Code:56367-7716
Mailing Address - Country:US
Mailing Address - Phone:320-292-0981
Mailing Address - Fax:
Practice Address - Street 1:34 135TH ST NE
Practice Address - Street 2:
Practice Address - City:RICE
Practice Address - State:MN
Practice Address - Zip Code:56367-7716
Practice Address - Country:US
Practice Address - Phone:320-292-0981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN301729101YA0400X
MNLPCC00382101YA0400X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional