Tracy M McDonald, LPCC

Individual provider Active NPI Professional Counselor · Whitley City, KY

NPI 1003255696 · NPPES record last updated May 11, 2021

Key facts

NPI
1003255696
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
239923 (KY)
Practice address
90 Medical LN
Whitley City, KY 42653-4216
Phone
(606) 376-2466
NPI assigned
Jun 18, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
239923KYMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 239923 KY Yes

Addresses

Primary practice location

90 Medical LN
Whitley City, KY 42653-4216

Mailing address

177 Les Gilreath Road
Stearns, KY 42647

Other names

  • Tracy M Johns Former name

Other providers in Whitley City, KY

All providers in Whitley City, KY · Professional Counselor in Kentucky

Sources for this page

Verify at the official NPI Registry.