Provider Demographics
NPI:1558067892
Name:BIAGAS, TRACEY MONIQUE (LGPC)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:MONIQUE
Last Name:BIAGAS
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4523 BESTOR DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-2139
Mailing Address - Country:US
Mailing Address - Phone:130-122-1085
Mailing Address - Fax:
Practice Address - Street 1:10 N JEFFERSON ST STE 203
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4865
Practice Address - Country:US
Practice Address - Phone:202-750-1028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13539101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health