MISS TRACY ANN DESRUISSEAUX LADC NPI 1841524923

NPI Information

NPI: 1841524923
Provider Name: MISS TRACY ANN DESRUISSEAUX, LADC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
585 LINCOLN ST
WORCESTER, MA
ZIP 01605
Phone: (508) 831-0045
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MISS Tracy Ann Desruisseaux, LADC is an addiction (substance use disorder) counselor in Worcester, MA. MISS Tracy Ann Desruisseaux, LADC NPI is 1841524923. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

585 LINCOLN ST
WORCESTER, MA
ZIP 01605-906
Phone: (508) 831-0045

The enumeration date for this NPI number is 9/23/2009 and was last updated on 9/23/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Y10400	MEDICARE UPIN	MASSACHUSETTS
2	1308785	MEDICAID	MASSACHUSETTS
3	22220002001	OTHER	MASSACHUSETTS	BLUE CROSS
4	M18684	OTHER	MASSACHUSETTS	BLUE CROSS
5	1306421	MEDICAID	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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