Provider Demographics
NPI:1700019395
Name:HAMB, TRACIE LYNNE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:TRACIE
Middle Name:LYNNE
Last Name:HAMB
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:TRACIE
Other - Middle Name:LYNNE
Other - Last Name:HURT-BELCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:PO BOX 337
Mailing Address - Street 2:
Mailing Address - City:SCARBRO
Mailing Address - State:WV
Mailing Address - Zip Code:25917-0337
Mailing Address - Country:US
Mailing Address - Phone:304-465-2385
Mailing Address - Fax:304-465-1518
Practice Address - Street 1:262 OYLER AVENUE
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:WV
Practice Address - Zip Code:25901
Practice Address - Country:US
Practice Address - Phone:304-469-6331
Practice Address - Fax:304-469-6332
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP003541104100000X
WVDP009447911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker