Individual provider Active NPI

Tracie Gillispie, LPC CAND.

  • Professional Counselor
  • Duncan, OK
National Provider Identifier
1194028183
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5018 Issued in OK
Practice address
23 N 8TH St
Duncan, OK 73533-4601
Phone
(580) 656-0265
NPI assigned
Dec 13, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X 5018 OK Primary

Addresses

Primary practice location

23 N 8TH St
Duncan, OK 73533-4601

Mailing address

808 Palm Dr
Duncan, OK 73533-3326
Phone (580) 656-0265

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tracie@gillispiecounseling.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20241119001750 OK Practitioner - Mental Health Counselor 3577935717 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5018OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gillispie Family Ministries Current Accepting new patients
Gillispie Counseling Services CurrentSince Aug 20, 2024 Accepting new patients

Locations

23 N 8th St
Duncan, OK 73533
Phone (580) 786-0583

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": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1194028183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 PALM DR",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735333326",
            "telephone_number": "580-656-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 N 8TH ST",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735334601",
            "telephone_number": "580-656-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLISPIE",
        "first_name": "TRACIE",
        "credential": "LPC CAND.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "5018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tracie@gillispiecounseling.com",
            "affiliation": "N",
            "address_1": "23 N 8th St",
            "city": "Duncan",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735334601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duncan, OK

Sources for this page

Verify at the official NPI Registry.