Provider Demographics
NPI:1871003814
Name:VALENTINE, TRACYE FREEMAN
Entity type:Individual
Prefix:MS
First Name:TRACYE
Middle Name:FREEMAN
Last Name:VALENTINE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#1106 2000 MALLORY LN, STE 290
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:38067
Mailing Address - Country:US
Mailing Address - Phone:615-326-9539
Mailing Address - Fax:731-213-1837
Practice Address - Street 1:#1106-2000 MALLORY LANE
Practice Address - Street 2:STE 290
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067
Practice Address - Country:US
Practice Address - Phone:615-326-9539
Practice Address - Fax:731-213-1837
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC7377101YP2500X
KS0364101YP2500X
AL05225101YP2500X
NE2928101YP2500X
MS3205101YP2500X
TN5903101YP2500X
NE3665101YM0800X
ID9071756101YP2500X
TX90073101YP2500X
GA014210101YP2500X
KY279366101YP2500X
WALH61364464101YP2500X
LA9390101YP2500X
UT13214018-6004101YP2500X
MO2023015512101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health