| Tracy P Smith Ma Licensed Psychologist Pllc | |
|
21 Cherokee Trl Elkview WV 25071-9263 | |
| (304) 965-0372 | |
| (304) 965-0372 |
| Full Name | Tracy P Smith Ma Licensed Psychologist Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 21 Cherokee Trl, Elkview, West Virginia |
| Authorized Official Name and Position | Tracy Pauley Smith (LICENSED PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 3045396222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracy P Smith Ma Licensed Psychologist Pllc 1511 Rambler Rd Charleston WV 25314-1830 Ph: (304) 539-6222 | Tracy P Smith Ma Licensed Psychologist Pllc 21 Cherokee Trl Elkview WV 25071-9263 Ph: (304) 965-0372 |
| NPI Number | 1043544471 |
|---|---|
| Provider Enumeration Date | 10/02/2009 |
| Last Update Date | 06/16/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043544471 | NPI | - | NPPES |
| 9205040000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 785 (West Virginia) | Primary |