Individual provider Active NPI

Tracy S Thompson, LMHC

  • Mental Health Counselor
  • Boynton Beach, FL
National Provider Identifier
1073865770
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH18220 Issued in FL
Practice address
602 Villa Cir
Boynton Beach, FL 33435-8913
Phone
(314) 853-8371
NPI assigned
Oct 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH18220 FL Primary

Addresses

Primary practice location

602 Villa Cir
Boynton Beach, FL 33435-8913

Mailing address

602 Villa Cir
Boynton Beach, FL 33435-8913
Phone (314) 853-8371

Other identifiers 1

IdentifierTypeStateIssuer
MH18220OtherFLSTATE OF FLORIDA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH18220FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1073865770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 VILLA CIR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334358913",
            "telephone_number": "314-853-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 VILLA CIR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334358913",
            "telephone_number": "314-853-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "TRACY",
        "middle_name": "S",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-05",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH18220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA",
            "identifier": "MH18220",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.