Provider Demographics
NPI:1366197923
Name:ADAMS, TRACY LEE (LCSW)
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:LEE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 THE CROSSINGS
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-4268
Mailing Address - Country:US
Mailing Address - Phone:850-499-5929
Mailing Address - Fax:
Practice Address - Street 1:5411 SKY CENTER DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1570
Practice Address - Country:US
Practice Address - Phone:813-939-2202
Practice Address - Fax:866-495-2009
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-12
Last Update Date:2025-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL113441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical