Provider Demographics
NPI:1417228560
Name:LANIER, TRACY ANN (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:ANN
Last Name:LANIER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N BROCKWAY ST STE 300
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-5063
Mailing Address - Country:US
Mailing Address - Phone:847-485-1640
Mailing Address - Fax:224-829-0646
Practice Address - Street 1:110 N BROCKWAY ST STE 300
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-5063
Practice Address - Country:US
Practice Address - Phone:847-485-1640
Practice Address - Fax:224-829-0646
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-21
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0138361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical