Bobbie Lynn Tracy, LADAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Crownpoint, NM
NPI 1043545932 · NPPES record last updated Oct 9, 2009
Key facts
- NPI
- 1043545932
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 0120661 (NM)
- Practice address
- Southwest Highland Drive
Crownpoint, NM 87313 - Phone
- (505) 786-2111
- Fax
- (505) 786-2020
- NPI assigned
- Oct 9, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0120661 | NM | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Navajo Nation Crownpoint Outpatient Treatment Center | Addiction (Substance Use Disorder) | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0120661 | NM | Yes |
Addresses
Primary practice location
Southwest Highland Drive
Crownpoint, NM 87313
Mailing address
Southwest Highland Drive
Crownpoint, NM 87313
Phone (505) 786-2111
Other providers in Crownpoint, NM
- Sophie Soo
- Roger William Studd
- Thoreau Health Station
- Theresa Tolth
- Karen Mai Linh Tong
- Tran Ngoc Tran
- US DHHS Crownpoint Healthcare Facility
- Bobilyn Jo Waite
- Keith Warshany
- Nazret Gaim Weldeghiorgis
All providers in Crownpoint, NM · Addiction (Substance Use Disorder) Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.