Active NPI
Tracy Dawn Chase, LPC
- Professional Counselor
- Victoria, TX
National Provider Identifier
1043591464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 65127
- Practice address
- 6502 Nursery Dr
Suite 100
Victoria, TX 77904-1178 - Phone
- (361) 575-0611
- Fax
- (361) 528-2327
- NPI assigned
- Aug 30, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 65127 | TX | |
| Professional Counselor | 101YP2500X | 65127 | TX | Primary |
Addresses
Primary practice location
6502 Nursery Dr
Suite 100
Victoria, TX 77904-1178
Mailing address
6502 Nursery Dr
Suite 100
Victoria, TX 77904-1178
Phone (361) 575-0611
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 65127 | Other | TX | LPC LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65127 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314662400000",
"number": "1043591464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6502 NURSERY DR",
"address_2": "SUITE 100",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779041178",
"telephone_number": "361-575-0611",
"fax_number": "361-528-2327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6502 NURSERY DR",
"address_2": "SUITE 100",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779041178",
"telephone_number": "361-575-0611",
"fax_number": "361-528-2327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHASE",
"first_name": "TRACY",
"middle_name": "DAWN",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-30",
"last_updated": "2011-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "65127",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "65127",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC LICENSE",
"identifier": "65127",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Victoria, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.