Provider Demographics
NPI:1619594488
Name:TRACEY, HELEN
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:TRACEY
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 1:1026 WOODSON RD
Mailing Address - Street 2:UNIT G
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-2971
Mailing Address - Country:US
Mailing Address - Phone:240-418-7480
Mailing Address - Fax:
Practice Address - Street 1:1026 WOODSON RD
Practice Address - Street 2:UNIT G
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2971
Practice Address - Country:US
Practice Address - Phone:240-418-7480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-28
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health