Doerr, Tracy
Doerr, Tracy is an sole proprietor health care provider with primary practice located at 10464 Hollywood Blvd Nw , Coon Rapids MN 55433-4517. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Doerr, Tracy can be contacted via phone (612) 900-8934.Contact Information
Primary practice address
10464 Hollywood Blvd Nw
Coon Rapids MN 55433-4517
Phone: (612) 900-8934
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 303832 | Minnesota |
Behavioral Health & Social Service Providers / Professional | 101YP2500X | 3801 | Minnesota |
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 3801 | Minnesota |
Profile Details
NPI number | 1194492025 |
---|---|
LBN Legal business name | Doerr, Tracy |
Credentials | LPCC/LADC |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 27th, 2021 |
Last updated | Feb 20th, 2024 - about 9 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1194492025 | NPPES |
Minnesota | MEDICAID | N204188757206 |
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