Provider Demographics
NPI:1649312372
Name:KELCE, TRACEY (LMHC)
Entity type:Individual
Prefix:MS
First Name:TRACEY
Middle Name:
Last Name:KELCE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4364 ACUSHNET AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745
Mailing Address - Country:US
Mailing Address - Phone:508-998-2700
Mailing Address - Fax:508-998-2176
Practice Address - Street 1:4364 ACUSHNET AVE
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745
Practice Address - Country:US
Practice Address - Phone:508-998-2700
Practice Address - Fax:508-998-2176
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10354101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA10354OtherLMHC