Individual provider Active NPI

Tracy L Mock, LMHC

  • Mental Health Counselor
  • Lawrenceburg, IN
National Provider Identifier
1245383629
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39001601A Issued in IN
Practice address
423 Eads Pkwy
Lawrenceburg, IN 47025
Phone
(812) 537-1302
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39001601A IN Primary

Addresses

Primary practice location

423 Eads Pkwy
Lawrenceburg, IN 47025

Mailing address

285 Bielby Rd
Lawrenceburg, IN 47025-1055
Phone (812) 537-1302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20231214003543 IN Practitioner - Mental Health Counselor 2163871179 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39001601AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health Center Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

285 Bielby Rd
Lawrenceburg, IN 47025
Phone (812) 537-1302

710 W Eads Pkwy
Lawrenceburg, IN 47025
Phone (812) 537-7382

Organizations & group practices 1

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245383629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 BIELBY RD",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "470251055",
            "telephone_number": "812-537-1302",
            "fax_number": "812-537-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 EADS PKWY",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "47025",
            "telephone_number": "812-537-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCK",
        "first_name": "TRACY",
        "middle_name": "L",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001601A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceburg, IN

Sources for this page

Verify at the official NPI Registry.