Provider Demographics
NPI:1790011039
Name:BARCOTT, TRACY REBEKAH DOBBINS (PH D)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:REBEKAH DOBBINS
Last Name:BARCOTT
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6115 PARK SOUTH DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3269
Mailing Address - Country:US
Mailing Address - Phone:704-552-0116
Mailing Address - Fax:704-552-7550
Practice Address - Street 1:8840 BLAKENEY PROFESSIONAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-6718
Practice Address - Country:US
Practice Address - Phone:704-552-0116
Practice Address - Fax:704-552-7550
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-21
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3853103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist