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:
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Health care specialties

SpecialtyCodeLicense #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 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194492025 NPPES
Minnesota MEDICAID N204188757206

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