| Tracy Durkin, Lcsw | |
|
628 Shrewsbury Ave Tinton Falls NJ 07701-4932 | |
| (732) 758-0550 | |
| (732) 758-0280 |
| Full Name | Tracy Durkin, Lcsw |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 628 Shrewsbury Ave, Tinton Falls, New Jersey |
| Authorized Official Name and Position | Tracy Durkin (OWNER) |
| Authorized Official Contact | 7327580550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracy Durkin, Lcsw 628 Shrewsbury Ave Tinton Falls NJ 07701-4932 Ph: (732) 758-0550 | Tracy Durkin, Lcsw 628 Shrewsbury Ave Tinton Falls NJ 07701-4932 Ph: (732) 758-0550 |
| NPI Number | 1568966430 |
|---|---|
| Provider Enumeration Date | 03/23/2018 |
| Last Update Date | 03/23/2018 |
| Medicare PECOS PAC ID | 2062764715 |
|---|---|
| Medicare Enrollment ID | O20181009000910 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568966430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 44SC01169800 (New Jersey) | Primary |
| Provider Name | Tracy L Durkin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962642223 PECOS PAC ID: 5496927949 Enrollment ID: I20111006000062 |
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