Provider Demographics
NPI:1821269671
Name:NORRIS, TRACY M (LCSW)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:M
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10421 68TH DR
Mailing Address - Street 2:APT: A27
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3455
Mailing Address - Country:US
Mailing Address - Phone:917-864-1901
Mailing Address - Fax:
Practice Address - Street 1:14601 45TH AVE STE 310
Practice Address - Street 2:FLUSHING HOSPITAL MENTAL HEALTH CLINIC
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2281
Practice Address - Country:US
Practice Address - Phone:718-670-5562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0814771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical