Provider Demographics
NPI:1851164172
Name:THOMPSON BARNES, TRACEY ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:TRACEY ANN
Middle Name:
Last Name:THOMPSON BARNES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16842 127TH AVE APT 2A
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3125
Mailing Address - Country:US
Mailing Address - Phone:347-896-4350
Mailing Address - Fax:
Practice Address - Street 1:2932 WILKINSON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4004
Practice Address - Country:US
Practice Address - Phone:347-544-0955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY121679104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker