| Doctor Name: | SHELLEY D TRACY |
| NPI Number: | 1073646188 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 39001352A |
| Business Practice Address: | 12015 Allisonville Rd Fishers, IN - 460382317 |
| Business Phone Number: | 3178418335 |
| Business Fax Number: | |
| Mailing Address: | 12015 Allisonville Rd, FISHERS |
| State: | IN |
| Postal Code: | 460382317 |
| Phone Number: | 3178418335 |
| Fax Number: | |
| NPI Enumeration Date: | 03/14/2007 |
| NPI Last Update Date: | 04/05/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 39001352A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |