Provider Demographics
NPI:1902386394
Name:NALORY, TRACY AYANNA (LCSW)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:AYANNA
Last Name:NALORY
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:PO BOX 5780
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37320-5780
Mailing Address - Country:US
Mailing Address - Phone:423-596-4186
Mailing Address - Fax:423-709-9992
Practice Address - Street 1:3505 ADKISSON DR NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-6803
Practice Address - Country:US
Practice Address - Phone:423-473-6731
Practice Address - Fax:423-709-9992
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN68691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical