Tracey Renee Bryant, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

164670 Issued in KY

Practice address

931 E Main Street
Cecilia, KY 42724-9624

Phone

(444) 350-9005

Fax

(270) 858-4029

NPI assigned

Sep 21, 2010

Last updated

Jul 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations (25 of 27)

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cumberland Family Medical Center Inc

  dba Cumberland Family Medical Center

  • Federally Qualified Health Center (FQHC)
  • Burkesville, KY
  • NPI 1306873500
  Medicare reassignment NPD
• Cumberland Family Medical Center Inc

  dba Metcalfe County Middle Healthy Kids Clinic

  • Federally Qualified Health Center (FQHC)
  • Edmonton, KY
  • NPI 1548953672
  NPD
• Cumberland Family Medical Center Inc

  dba Albany Elementary Healthy Kids Clinic

  • Federally Qualified Health Center (FQHC)
  • Albany, KY
  • NPI 1942682547
  NPD

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1053629212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 E MAIN STREET",
            "city": "CECILIA",
            "state": "KY",
            "postal_code": "427249624",
            "telephone_number": "444-350-9005",
            "fax_number": "270-858-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "TRACEY",
        "middle_name": "RENEE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-21",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "164670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12164366",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100394470",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan C Ashabraner, CSW
• McKayla Ashton Basham, APRN
• Rachel Mae Benavidez, M. S., CCC-SLP
• Travis L Billings, LCSW
• Bethany Larimore Brown, LPCC
• Tamara Sue Carder, LCSW
• Christie Carr
• Sharon Elizabeth Conley, LPCC
• Cornerstone Counseling Center, PLLC (Cornerstone Counseling Center)
• Cumberland Family Medical Center Inc (West Hardin Middle Healthy Kids Clinic)

• Professional Counselor in Cecilia, KY
• Providers in Cecilia, KY by specialty
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.