Provider Demographics
NPI:1740546092
Name:TRACI MURACCO, LPC
Entity type:Organization
Organization Name:TRACI MURACCO, LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:MURACCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-905-7945
Mailing Address - Street 1:1325 RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18702
Mailing Address - Country:US
Mailing Address - Phone:570-905-7945
Mailing Address - Fax:570-824-5417
Practice Address - Street 1:1325 N RIVER ST
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18702-1838
Practice Address - Country:US
Practice Address - Phone:570-905-7945
Practice Address - Fax:570-824-5417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006262101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty