Tracy Lou Klucina, LCAS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

944 Issued in NC

Practice address

3430 Wheatley Ave
Charlotte, NC 28205-7654

Phone

(704) 591-2026

Fax

(704) 336-6559

NPI assigned

Feb 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Mecklenburg County Area Mental Health

  • Counselor
  • Charlotte, NC
  • NPI 1023259975
  NPD (past)
• Mecklenburg County Area Mental Health Authority

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1538241351
  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184761520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 WHEATLEY AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057654",
            "telephone_number": "704-591-2026",
            "fax_number": "704-336-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 WHEATLEY AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057654",
            "telephone_number": "704-591-2026",
            "fax_number": "704-336-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUCINA",
        "first_name": "TRACY",
        "middle_name": "LOU",
        "name_prefix": "Ms.",
        "credential": "LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6111873",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Keith Klopotowski, MD
• Erica Diane Klose, NNP
• Rachel Ann Kloss, LLMSW
• Cynthia Ann Klotz, PHARMD. , CPP
• Darrell Alexander Klotz, M.D.
• Megan Rose Kluesner, NP
• Alyssa Danielle Klus, PHARMD, RPH
• Bryan Kluttz, LCSW
• Caroline Rae Kluttz, MS, RDN, LDN
• KMB Transportation LLC

• Addiction (Substance Use Disorder) Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.