Provider Demographics
NPI:1447334495
Name:KASPER-O'HEARNE, TRACY LYNN (LMHC)
Entity type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:LYNN
Last Name:KASPER-O'HEARNE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 PRECINCT ST
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02347-1425
Mailing Address - Country:US
Mailing Address - Phone:508-947-8305
Mailing Address - Fax:
Practice Address - Street 1:81 SAMOSET ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4500
Practice Address - Country:US
Practice Address - Phone:508-269-7877
Practice Address - Fax:508-591-8214
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5160101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2154702OtherCIGNA