Provider Demographics
NPI:1609540582
Name:YOUNG, TRACY RUFF
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:RUFF
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-3351
Mailing Address - Country:US
Mailing Address - Phone:803-276-5690
Mailing Address - Fax:
Practice Address - Street 1:800 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108-3351
Practice Address - Country:US
Practice Address - Phone:803-276-5690
Practice Address - Fax:803-321-2234
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)