| Doctor Name: | MICHAEL W TRACY |
| NPI Number: | 1033312285 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | LCSW-712 |
| Business Practice Address: | 411 N Brigham Ave American Fork, UT - 840031835 |
| Business Phone Number: | 8018882935 |
| Business Fax Number: | |
| Mailing Address: | 210 W 400 N, AMERICAN FORK |
| State: | UT |
| Postal Code: | 840031567 |
| Phone Number: | 8018882935 |
| Fax Number: | |
| NPI Enumeration Date: | 06/06/2007 |
| NPI Last Update Date: | 07/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCSW-712 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |