Provider Demographics
NPI:1952544074
Name:HERRERA, TRACY JEANNE (LPC)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:JEANNE
Last Name:HERRERA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:TRACY
Other - Middle Name:JEANNE
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45 WESTERN TER
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19363-1307
Mailing Address - Country:US
Mailing Address - Phone:610-467-1467
Mailing Address - Fax:
Practice Address - Street 1:811 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-4844
Practice Address - Country:US
Practice Address - Phone:610-308-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006209101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional