Individual provider Active NPI

Tracy Mills Eckert, LPC, LADC

  • Professional Counselor
  • Canton, CT
National Provider Identifier
1154476927
Registry record updated Mar 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
101YP2500X Issued in CT
Practice address
59 E Hill Rd
Canton, CT 06019-2215
Phone
(860) 965-7500
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2020

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 101YA0400X CT
Professional Counselor 101YP2500X 101YP2500X CT Primary

Addresses

Primary practice location

59 E Hill Rd
Canton, CT 06019-2215

Mailing address

22 Camille LN
Canton, CT 06019-2040
Phone (860) 965-7500

Other practice location 1

21 Montauk Ave
New London, CT 06320-4906
Phone (860) 271-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240223002644 CT Practitioner - Mental Health Counselor 4688019193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

59 E Hill Rd
Canton, CT 06019-2215
Phone (860) 965-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101YA0400XCTMDAddiction (Substance Use Disorder) Counselor
101YP2500XCTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tracy Eckert LLC Addiction (Substance Use Disorder) CurrentSince Jan 1, 2024 Accepting new patients
Sound Community Services, Inc. PastSince Apr 25, 2010 Accepting new patients

Locations

59 E Hill Rd
Canton, CT 06019
Phone (860) 965-7500

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/soundcommunityservices/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584230400000",
    "number": "1154476927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CAMILLE LN",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060192040",
            "telephone_number": "860-965-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 E HILL RD",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060192215",
            "telephone_number": "860-965-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Montauk Ave",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "CT",
            "postal_code": "063204906",
            "country_code": "US",
            "telephone_number": "860-271-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ECKERT",
        "first_name": "TRACY",
        "middle_name": "MILLS",
        "credential": "LPC, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-03-15",
        "certification_date": "2020-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "101YA0400X",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "101YP2500X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, CT

Sources for this page

Verify at the official NPI Registry.