Provider Demographics
NPI:1013215391
Name:HUFF, TRACEY JEAN (LCSW)
Entity type:Individual
Prefix:MISS
First Name:TRACEY
Middle Name:JEAN
Last Name:HUFF
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 1:45 NORTH BROAD STREET
Mailing Address - Street 2:SUITE 505
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3822
Mailing Address - Country:US
Mailing Address - Phone:201-805-1517
Mailing Address - Fax:
Practice Address - Street 1:45 NORTH BROAD STREET
Practice Address - Street 2:SUITE 505
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3822
Practice Address - Country:US
Practice Address - Phone:201-805-1517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05409400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker