Individual provider Active NPI

Tracy M Humphress, SAC-IT

  • Addiction (Substance Use Disorder) Counselor
  • Eau Claire, WI
National Provider Identifier
1114436326
Registry record updated Sep 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
17481 Issued in WI
Practice address
3440 Oakwood Hills Pkwy
Eau Claire, WI 54701-7698
Phone
(715) 214-2525
NPI assigned
Sep 20, 2017
Last updated
Sep 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 17481 WI Primary

Addresses

Primary practice location

3440 Oakwood Hills Pkwy
Eau Claire, WI 54701-7698

Mailing address

13287 44TH Ave
Chippewa Falls, WI 54729-7303
Phone (715) 703-0261

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

LicenseStateTypeSpecialty
17481WIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505865600000",
    "number": "1114436326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13287 44TH AVE",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547297303",
            "telephone_number": "17157030261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 OAKWOOD HILLS PKWY",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547017698",
            "telephone_number": "715-214-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHRESS",
        "first_name": "TRACY",
        "middle_name": "M",
        "credential": "SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2017-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.