Tracy P Smith Ma Licensed Psychologist PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

785 Issued in WV

Legal business name

TRACY P SMITH MA LICENSED PSYCHOLOGIST PLLC

Practice address

21 Cherokee TRL
Elkview, WV 25071-9263

Phone

(304) 965-0372

Fax

(304) 965-0372

NPI assigned

Oct 2, 2009

Last updated

Jun 16, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Tracy Pauley Smith, MA

Title

Licensed Psychologist/Owner

Phone

(304) 539-6222

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tracy Lynn Smith, MA

  • Psychologist
  • Charleston, WV
  • NPI 1417067539
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402876800000",
    "number": "1043544471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 RAMBLER RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253141830",
            "telephone_number": "304-539-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CHEROKEE TRL",
            "city": "ELKVIEW",
            "state": "WV",
            "postal_code": "250719263",
            "telephone_number": "304-965-0372",
            "fax_number": "304-965-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY P SMITH MA LICENSED PSYCHOLOGIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-02",
        "last_updated": "2014-06-16",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "PAULEY",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "304-539-6222",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": "785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9205040000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chrystal Stricklen
• Daniel Steven Summers, R.N
• Regan Summers
• Marcy Thomas
• Jayla Thompson
• Walgreen Co (Walgreens #19090)
• West Virginia CVS Pharmacy LLC (CVS Pharmacy 05957)
• Kathryn White
• Timothy White
• Tessa Wickline

• Psychologist in Elkview, WV
• Providers in Elkview, WV by specialty
• Psychologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.