Tracey Wisdom, LCDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

201 Pine Tree Rd
Longview, TX 75604-4140

Phone

(903) 759-4966

NPI assigned

Feb 20, 2025

Sex

Female

Sole proprietor

Yes

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

Practice roles

Locations

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.

• East Texas Clinic Inc

  • Methadone Clinic
  • Longview, TX
  • NPI 1851045595
  NPD

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1174329262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PINE TREE RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756044140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PINE TREE RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756044140",
            "telephone_number": "903-759-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISDOM",
        "first_name": "TRACEY",
        "credential": "LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hunter Wink, RBT
• Winnie-Stowell Hospital District (Treviso Transitional Care)
• Winnie-Stowell Hospital District (Treviso Transitional Care)
• Chelsey Winningham, FNP-C
• Winsted Psychological Services, PLLC
• Betty Jane Witherspoon, LMSW
• David R Witt, MD
• Holly Witt
• Mark A Witt, DPM
• Dorothy McKenzie Womack, FNP-C

• Addiction (Substance Use Disorder) Counselor in Longview, TX
• Providers in Longview, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

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

Verify at the official NPI Registry.