Provider Demographics
NPI:1295745669
Name:TRACY, SCOTT LEE (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:LEE
Last Name:TRACY
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 RANKIN RD
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-4817
Mailing Address - Country:US
Mailing Address - Phone:724-323-6008
Mailing Address - Fax:724-626-4444
Practice Address - Street 1:2001 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:LEMONT FURNACE
Practice Address - State:PA
Practice Address - Zip Code:15456-1029
Practice Address - Country:US
Practice Address - Phone:724-626-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2016-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003297101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional