John M. Tracy, PHD, LLC

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

Legal business name

JOHN M. TRACY, PHD, LLC

Practice address

3312 Kaliste Saloom Rd BLDG 1
Lafayette, LA 70508-7449

Phone

(337) 534-0727

Fax

(337) 534-0737

NPI assigned

Jul 21, 2023

Organization subpart

No

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

Authorized official

Name

Dr. John M Tracy, PHD, MPNPI 1437650330

Title

Medical and Counseling Psychologist

Phone

(337) 534-0727

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John McCreary Tracy, PH.D.

  • Counseling Psychologist
  • Lafayette, LA
  • NPI 1437650330
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1124708458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 TECHE DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 KALISTE SALOOM RD BLDG 1",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087449",
            "telephone_number": "337-534-0727",
            "fax_number": "337-534-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN M. TRACY, PHD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A",
        "authorized_official_last_name": "TRACY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL AND COUNSELING PSYCHOLOGIST",
        "authorized_official_telephone_number": "337-534-0727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, MP"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prescribing (Medical) Psychologist in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Prescribing (Medical) Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.