Provider Demographics
NPI:1700429321
Name:STRABEL, TRACIE SARA (LCSW, BC-TMH)
Entity Type:Individual
Prefix:MS
First Name:TRACIE
Middle Name:SARA
Last Name:STRABEL
Suffix:
Gender:F
Credentials:LCSW, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4988 CHUGG RD
Mailing Address - Street 2:
Mailing Address - City:HOLLEY
Mailing Address - State:NY
Mailing Address - Zip Code:14470-9713
Mailing Address - Country:US
Mailing Address - Phone:585-313-9926
Mailing Address - Fax:
Practice Address - Street 1:4988 CHUGG RD
Practice Address - Street 2:
Practice Address - City:HOLLEY
Practice Address - State:NY
Practice Address - Zip Code:14470-9713
Practice Address - Country:US
Practice Address - Phone:585-313-9926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-27
Last Update Date:2019-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0821241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical