Provider Demographics
NPI:1922406057
Name:SMITH HASSETT, TRACEY K (MA, NCC, CCMHC, CPC)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:K
Last Name:SMITH HASSETT
Suffix:
Gender:F
Credentials:MA, NCC, CCMHC, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:985 DAMONTE RANCH PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-1911
Mailing Address - Country:US
Mailing Address - Phone:713-927-2864
Mailing Address - Fax:
Practice Address - Street 1:985 DAMONTE RANCH PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-1911
Practice Address - Country:US
Practice Address - Phone:713-927-2864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65314101YP2500X
NVCP0126101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional