John M. Tracy, Phd, Llc | |
3312 Kaliste Saloom Rd Bldg 1 Lafayette LA 70508-7449 | |
(337) 534-0727 | |
(337) 534-0737 |
Full Name | John M. Tracy, Phd, Llc |
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Speciality | Psychologist |
Location | 3312 Kaliste Saloom Rd Bldg 1, Lafayette, Louisiana |
Authorized Official Name and Position | John M Tracy (MEDICAL AND COUNSELING PSYCHOLOGIST) |
Authorized Official Contact | 3375340727 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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John M. Tracy, Phd, Llc 139 Teche Dr Lafayette LA 70503-2537 Ph: () - | John M. Tracy, Phd, Llc 3312 Kaliste Saloom Rd Bldg 1 Lafayette LA 70508-7449 Ph: (337) 534-0727 |
NPI Number | 1124708458 |
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Provider Enumeration Date | 07/21/2023 |
Last Update Date | 07/21/2023 |
Certification Date | 07/21/2023 |
Medicare PECOS PAC ID | 1355702242 |
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Medicare Enrollment ID | O20231016000438 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124708458 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TP0016X | Psychologist - Prescribing (medical) | (* (Not Available)) | Primary |
Provider Name | John M Tracy |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1437650330 PECOS PAC ID: 1355606336 Enrollment ID: I20180522000441 |
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