Provider Demographics
NPI:1508436171
Name:OLSZEWSKI, TRACY ANN (LLPC,)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:ANN
Last Name:OLSZEWSKI
Suffix:
Gender:F
Credentials:LLPC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5295 NOTTINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:ALMONT
Mailing Address - State:MI
Mailing Address - Zip Code:48003-7810
Mailing Address - Country:US
Mailing Address - Phone:248-840-6346
Mailing Address - Fax:
Practice Address - Street 1:5295 NOTTINGHAM DR
Practice Address - Street 2:
Practice Address - City:ALMONT
Practice Address - State:MI
Practice Address - Zip Code:48003-7810
Practice Address - Country:US
Practice Address - Phone:248-840-6346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401019415101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor