Tracie Jennifer Stewart, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5793-125 Issued in WI

Practice address

3900 W Brown Deer Rd
Suite a, PMB 117
Brown Deer, WI 53209

Phone

(414) 465-8101

NPI assigned

Sep 11, 2013

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

Credentials

Master of Science

State licenses

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.

• Paramount Counseling Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Whitefish Bay, WI
  • NPI 1336948306
  NPD Authorized official

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1194150037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 W BROWN DEER RD STE A",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532091220",
            "telephone_number": "414-465-8101",
            "fax_number": "414-448-6944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W BROWN DEER RD",
            "address_2": "SUITE A, PMB 117",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "53209",
            "telephone_number": "414-465-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "TRACIE",
        "middle_name": "JENNIFER",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-11",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5793-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194150037",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Ray Snetselaar, DPT
• Karansinh Bharatsinh Solanki, DMD
• Michael Adam Staszewski, SAC-IT
• Kyle J Stecker
• Adrianna Stewart
• William Paul Stewart, MSW
• Emily Paige Stieve
• Jasmine Stocki
• Melissa Marie Stoeger, PTA
• Sarah Tambi Tambe

• Professional Counselor in Brown Deer, WI
• Providers in Brown Deer, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; 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.