| Tracey Malesa-wheaton, Lcsw, Llc | |
|
429 W Lasalle Ave Apt 2 South Bend IN 46601-1166 | |
| (574) 520-8444 | |
| (574) 367-2154 |
| Full Name | Tracey Malesa-wheaton, Lcsw, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 429 W Lasalle Ave Apt 2, South Bend, Indiana |
| Authorized Official Name and Position | Tracey Malesa-wheaton (OWNER) |
| Authorized Official Contact | 5745204444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracey Malesa-wheaton, Lcsw, Llc 429 W Lasalle Ave Apt 2 South Bend IN 46601-1166 Ph: (574) 520-8444 | Tracey Malesa-wheaton, Lcsw, Llc 429 W Lasalle Ave Apt 2 South Bend IN 46601-1166 Ph: (574) 520-8444 |
| NPI Number | 1912696451 |
|---|---|
| Provider Enumeration Date | 05/02/2023 |
| Last Update Date | 03/12/2024 |
| Certification Date | 03/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912696451 | NPI | - | NPPES |
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