Doctor Name: | MS. TRACY ANN LIVECCHI |
NPI Number: | 1023168804 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 18858 |
Business Practice Address: | 530 Wilshire Blvd Ste 310 Santa Monica, CA - 904011426 |
Business Phone Number: | 3108276301 |
Business Fax Number: | |
Mailing Address: | 2924 Clune Ave, VENICE |
State: | CA |
Postal Code: | 902914656 |
Phone Number: | 3108276301 |
Fax Number: | |
NPI Enumeration Date: | 01/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 18858 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |