Provider Demographics
NPI:1932439239
Name:KENELA, TRACY COLLEEN (MA, LMHC, CRC)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:COLLEEN
Last Name:KENELA
Suffix:
Gender:F
Credentials:MA, LMHC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 7TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1548
Mailing Address - Country:US
Mailing Address - Phone:360-259-9231
Mailing Address - Fax:360-459-2290
Practice Address - Street 1:924 7TH AVE SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1548
Practice Address - Country:US
Practice Address - Phone:360-259-9231
Practice Address - Fax:360-459-2290
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2013-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health