Active NPI
Tracy L Anderson, LPC
- Clinical Social Worker
- Escanaba, MI
National Provider Identifier
1104022029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6401010067
- Practice address
- 1100 Ludington St
Suite 401
Escanaba, MI 49829-3542 - Phone
- (906) 789-1596
- Fax
- (906) 789-2024
- NPI assigned
- Jun 26, 2007
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 6401010067 | MI | |
| Clinical Social Worker | 1041C0700X | 6401010067 | MI | Primary |
Addresses
Primary practice location
1100 Ludington St
Suite 401
Escanaba, MI 49829-3542
Mailing address
1100 Ludington St Ste 401
Escanaba, MI 49829-3545
Phone (906) 789-1596
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 |
|---|---|---|---|
| 6401010067 | MI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1104022029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 LUDINGTON ST STE 401",
"city": "ESCANABA",
"state": "MI",
"postal_code": "498293545",
"telephone_number": "906-789-1596",
"fax_number": "906-789-2024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 LUDINGTON ST",
"address_2": "SUITE 401",
"city": "ESCANABA",
"state": "MI",
"postal_code": "498293542",
"telephone_number": "906-789-1596",
"fax_number": "906-789-2024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "TRACY",
"middle_name": "L",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-26",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MI",
"license": "6401010067",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6401010067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Escanaba, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.