Tracy Doran, LPCC-S | |
38882 Mentor Ave, Willoughby, OH 44094-7875 | |
(440) 953-9999 | |
(440) 918-3839 |
Full Name | Tracy Doran |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 38882 Mentor Ave, Willoughby, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578953576 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | E.0008109-SL (Ohio) | Primary |
Entity Name | Phoenix Counseling Center Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801309141 PECOS PAC ID: 3577902451 Enrollment ID: O20240412000370 |
Mailing Address | Practice Location Address |
---|---|
Tracy Doran, LPCC-S 38882 Mentor Ave, Willoughby, OH 44094-7875 Ph: (440) 953-9999 | Tracy Doran, LPCC-S 38882 Mentor Ave, Willoughby, OH 44094-7875 Ph: (440) 953-9999 |
Tatiana Dwyer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 38882 Mentor Ave, Willoughby, OH 44094 Phone: 440-953-9999 | |
Niels William Nielsen, LISW Counselor Medicare: Not Enrolled in Medicare Practice Location: 38879 Mentor Ave, Suite C, Willoughby, OH 44094 Phone: 440-953-9999 Fax: 440-918-3839 | |
Shelly L. Beal, Counselor Medicare: Not Enrolled in Medicare Practice Location: 38882 Mentor Ave, Willoughby, OH 44094 Phone: 440-953-9999 | |
Jennifer Elizabeth Vittek, Counselor Medicare: Medicare Enrolled Practice Location: 38882 Mentor Ave, Willoughby, OH 44094 Phone: 440-953-9999 | |
Dana Elizabeth Knight, Counselor Medicare: Not Enrolled in Medicare Practice Location: 38882 Mentor Ave, Willoughby, OH 44094 Phone: 440-953-9999 | |
Melissa Louise Kahl, Counselor Medicare: Not Enrolled in Medicare Practice Location: 38882 Mentor Ave, Willoughby, OH 44094 Phone: 440-953-9999 | |
Adam Taylor Dawson, RN Counselor Medicare: Not Enrolled in Medicare Practice Location: 38882 Mentor Ave, Willoughby, OH 44094 Phone: 440-953-9999 |