Tracy Sibley

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

12.013972 Issued in CT

Practice address

300 Hebron Ave
Glastonbury, CT 06033-2176

Phone

(860) 383-3860

NPI assigned

Oct 5, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Connecticut Behavioral Health Assoc, P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, CT
  • NPI 1629158126

  Psychiatric/Mental Health

  NPD (past)
• Quest Diagnostics LLC

  • Clinical Medical Laboratory
  • Norwich, CT
  • NPI 1609185883
  NPD (past)

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

{
    "created_epoch": "1728086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728086400000",
    "number": "1083433239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MEADOW LN",
            "city": "SALEM",
            "state": "CT",
            "postal_code": "064203521",
            "telephone_number": "860-383-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HEBRON AVE",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332176",
            "telephone_number": "860-383-3860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Case St",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063602215",
            "country_code": "US",
            "telephone_number": "860-823-1399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIBLEY",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-05",
        "last_updated": "2024-10-05",
        "certification_date": "2024-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "12.013972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanta Shepherd, M.D,
• Lorin Sher, DMD, PHD
• Sheryll Waring LPC Ladc LLC
• Lisa Shettle, RDN CDN
• Kathleen Ann Shimwell, LCSW
• Alisa Sue Siegfeld, M.D.
• Jessica Marie Siervo
• Laura R Sievering, PA-C
• Lois Eve Sigman-Young, MSW
• Katherine Simoniello

• Psychiatric/Mental Health Nurse Practitioner in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.