Provider Demographics
NPI:1831608041
Name:SEERY, TRACI
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:
Last Name:SEERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22902 LINDEN DR
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-5137
Mailing Address - Country:US
Mailing Address - Phone:434-305-5870
Mailing Address - Fax:
Practice Address - Street 1:22902 LINDEN DR
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-5137
Practice Address - Country:US
Practice Address - Phone:434-305-5870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEFT-0000037106H00000X
VA0717001392106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist