Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Tracylynn Huntley Wickham, LCSW

Individual provider Clinical Social Worker · NPI 1194003459

Mrs. Tracylynn Huntley Wickham, LCSW is a Clinical Social Worker in Richmond, Virginia. Qualified in 2004, 22 years ago. Practices with Dominion Outpatient Services LLC, a 4-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Virginia.

Years since qualifying
22
Licensed in
VA
In the registry since
2011
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

5412 Glenside Dr Ste F
Richmond, VA 23228-3995
Phone: (804) 282-5880
Fax: (804) 288-2029
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 0904006713 (VA)

Record details

NPI number1194003459
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedAugust 3, 2011
Last updated in NPPESSeptember 4, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Dominion Outpatient Services Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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