Provider Demographics
NPI:1922296615
Name:MAYES, TRACY JAMES (MA LCPC)
Entity Type:Individual
Prefix:MR
First Name:TRACY
Middle Name:JAMES
Last Name:MAYES
Suffix:
Gender:M
Credentials:MA LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6851 N TRIPP AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-4723
Mailing Address - Country:US
Mailing Address - Phone:636-734-9457
Mailing Address - Fax:
Practice Address - Street 1:4732 N AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-3785
Practice Address - Country:US
Practice Address - Phone:636-734-9457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health