Provider Demographics
NPI:1770829244
Name:WINTERS, TRACEY LEIGH (LMSW)
Entity type:Individual
Prefix:MS
First Name:TRACEY
Middle Name:LEIGH
Last Name:WINTERS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:TRACY
Other - Middle Name:LEIGH
Other - Last Name:WINTERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:217 SE 4TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66603-3504
Mailing Address - Country:US
Mailing Address - Phone:785-271-6657
Mailing Address - Fax:785-232-1373
Practice Address - Street 1:217 SE 4TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66603-3504
Practice Address - Country:US
Practice Address - Phone:785-271-6657
Practice Address - Fax:785-232-1373
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS79861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical