Provider Demographics
NPI:1902171267
Name:KAREL, TRACY LYNN (LMSW)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:LYNN
Last Name:KAREL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:LYNN
Other - Last Name:WINDSOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:109 SW SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-1761
Mailing Address - Country:US
Mailing Address - Phone:816-524-6071
Mailing Address - Fax:
Practice Address - Street 1:411 W MAPLE AVE STE C
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64050-2840
Practice Address - Country:US
Practice Address - Phone:816-225-2570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011032270104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker