Provider Demographics
NPI:1629685391
Name:WHEELER, TRACY (LISW-S)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:WHEELER
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4661 SAWMILL RD STE 3
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-6123
Mailing Address - Country:US
Mailing Address - Phone:855-857-6050
Mailing Address - Fax:937-548-1500
Practice Address - Street 1:4661 SAWMILL RD STE 3
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-6123
Practice Address - Country:US
Practice Address - Phone:614-364-4680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.22041471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical