Smith, Traci Mutzabaugh
Smith, Traci Mutzabaugh is an individual health care provider with primary practice located at 3580 Forest Haven Ln Suite B, Chesapeake VA 23321-5134. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Smith, Traci Mutzabaugh can be contacted via phone (757) 398-2881.Contact Information
Primary practice address
3580 Forest Haven Ln Suite B
Chesapeake VA 23321-5134
Phone: (757) 398-2881
Fax: (757) 483-0707
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 0904005929 | Virginia |
Profile Details
| NPI number | 1477589372 |
|---|---|
| LBN Legal business name | Smith, Traci Mutzabaugh |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years 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 | 1477589372 | NPPES |
| Virginia | Other | 11433361 | CAQH |
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