Provider Demographics
NPI:1891957692
Name:BYRA, TRACEY MARIE (LPC LMHC CEAP)
Entity Type:Individual
Prefix:MS
First Name:TRACEY
Middle Name:MARIE
Last Name:BYRA
Suffix:
Gender:F
Credentials:LPC LMHC CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 NORTH MARGIN STREET
Mailing Address - Street 2:UNIT #4
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02113
Mailing Address - Country:US
Mailing Address - Phone:919-434-6680
Mailing Address - Fax:
Practice Address - Street 1:66 N MARGIN ST
Practice Address - Street 2:APT 4
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02113-1679
Practice Address - Country:US
Practice Address - Phone:919-434-6680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5315101YM0800X
NC3579101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health