Provider Demographics
NPI:1760037196
Name:FREITAS, TRACY (MS, LPC)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:FREITAS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:
Other - Last Name:RAPPOLD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:1825 E LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-2407
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1825 E LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-2407
Practice Address - Country:US
Practice Address - Phone:610-466-9250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPCC008501101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional