Provider Demographics
NPI:1326103458
Name:WINCHESTER HILLMER, TRACY A (LSCSW)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:A
Last Name:WINCHESTER HILLMER
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:MS
Other - First Name:TRACY
Other - Middle Name:A
Other - Last Name:WINCHESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:723 MAIN
Mailing Address - Street 2:
Mailing Address - City:GOODLAND
Mailing Address - State:KS
Mailing Address - Zip Code:67735
Mailing Address - Country:US
Mailing Address - Phone:785-899-5991
Mailing Address - Fax:985-899-2533
Practice Address - Street 1:723 MAIN
Practice Address - Street 2:
Practice Address - City:GOODLAND
Practice Address - State:KS
Practice Address - Zip Code:67735
Practice Address - Country:US
Practice Address - Phone:785-899-5991
Practice Address - Fax:785-899-2533
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW 23311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
069753OtherBCBS
069753OtherBCBS