Individual provider Active NPI

Tracey M Gusman, LPC, SAC,NCC

  • Professional Counselor
  • Weston, WI
National Provider Identifier
1083143291
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7316 Issued in WI
Practice address
6304 Kelly PL
Weston, WI 54476-4397
Phone
(715) 574-5577
Fax
(715) 679-3080
NPI assigned
Jun 9, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X 7316 WI Primary

Addresses

Primary practice location

6304 Kelly PL
Weston, WI 54476-4397

Mailing address

6304 Kelly PL
Weston, WI 54476-4397
Phone (715) 574-5577

Other names 1

  • Tracey M Spatz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20240412001201 WI Practitioner - Mental Health Counselor 4688013477 Practice locations: Weston, WI

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6304 Kelly PL
Weston, WI 54476-4397
Phone (715) 574-5577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1083143291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6304 KELLY PL",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544764397",
            "telephone_number": "715-574-5577",
            "fax_number": "715-679-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6304 KELLY PL",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544764397",
            "telephone_number": "715-574-5577",
            "fax_number": "715-679-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSMAN",
        "first_name": "TRACEY",
        "middle_name": "M",
        "credential": "LPC, SAC,NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "SPATZ",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Weston, WI

Sources for this page

Verify at the official NPI Registry.