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TRACY L PEDERSON LCDCIII, SWA
NPI 1134624943
Counselor - Addiction (Substance Use Disorder) in Waverly, OH

Active since March 26, 2018
102 DAWN LN, WAVERLY, OH 45690(740) 947-7783 Get Directions Write a Review

NPPES record last updated: March 26, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Tracy L Pederson Lcdciii, Swa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRACY L PEDERSON LCDCIII, SWA (NPI 1134624943) is an individual addiction (substance use disorder) provider in Waverly, Ohio, licensed in Ohio (161646) and active in the NPI registry since March 2018.

NPPES Registry Identity

NPI1134624943
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameTRACY L PEDERSONCredential: LCDCIII, SWA
Location Address102 DAWN LNWaverly, OH 45690-9695
Mailing Address102 Dawn LnWaverly, OH 45690-9695 · (740) 947-7783
Phone(740) 947-7783
Sole ProprietorYes
Enumeration DateMarch 26, 2018
✔ NPI 1134624943 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OH · 161646
102 DAWN LN, Waverly, OH 45690
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Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRENT J WING CT,CDA
Counselor
102 DAWN LN
WAVERLY, OH 45690
Pike County (740) 947-7783
MS. PATRICIA MAY BARNETT QMHS
Case Manager/Care Coordinator
102 DAWN LN
WAVERLY, OH 45690
Pike County (740) 947-7783
TABITHA S JOHNSON RN
Registered Nurse
102 DAWN LN
WAVERLY, OH 45690
Pike County (740) 947-7783
ASHLEY LEETH PC
Counselor (Professional)
102 DAWN LN
WAVERLY, OH 45690
Pike County (740) 772-7892
BETTY BREWSTER RN
Registered Nurse
102 DAWN LN
WAVERLY, OH 45690
Pike County (740) 947-7783
MS. CAROL L HUNTER LSW
Social Worker
102 DAWN LN
WAVERLY, OH 45690
Pike County (740) 947-7783
COURTNEY PAIGE KINNAMON
Counselor (Addiction (Substance Use Disorder))
102 DAWN LN
WAVERLY, OH 45690
Pike County (740) 947-7783
CASSIDY WILBURN
Social Worker
102 DAWN LN
WAVERLY, OH 45690
Pike County (740) 947-7783

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tracy Pederson's NPI number?

The NPI number for Tracy Pederson is 1134624943. It was assigned to this individual provider in the NPPES registry on March 26, 2018.

Where is Tracy Pederson located?

Tracy Pederson practices at 102 Dawn Ln, Waverly, OH 45690. The listed phone number is (740) 947-7783.

What is Tracy Pederson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Tracy Pederson was last updated on March 26, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.