Provider Demographics
NPI:1356437750
Name:TRACY, HOLLY J (LPC, LMFT, CTS, NCC)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:J
Last Name:TRACY
Suffix:
Gender:F
Credentials:LPC, LMFT, CTS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MAYCOX AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-3433
Mailing Address - Country:US
Mailing Address - Phone:757-769-7040
Mailing Address - Fax:757-769-7050
Practice Address - Street 1:110 MAYCOX AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-3433
Practice Address - Country:US
Practice Address - Phone:757-769-7040
Practice Address - Fax:757-769-7050
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004033101YP2500X
VA0717001120106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist