Provider Demographics
NPI:1578643433
Name:HART, TRACI MICHELLE (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:TRACI
Middle Name:MICHELLE
Last Name:HART
Suffix:
Gender:
Credentials:MA, LPC
Other - Prefix:MISS
Other - First Name:TRACI
Other - Middle Name:MICHELLE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:8301 E PRENTICE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2906
Mailing Address - Country:US
Mailing Address - Phone:720-489-8555
Mailing Address - Fax:720-489-8304
Practice Address - Street 1:8301 E PRENTICE AVE STE 300
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2906
Practice Address - Country:US
Practice Address - Phone:720-489-8555
Practice Address - Fax:720-489-8304
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5111101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional