Tracy T. Nichols, MA, LPT, LSPE

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

1185 Issued in AL

Practice address

2011 Gallatin St SW
Huntsville, AL 35801-4510

Phone

(938) 902-0494

NPI assigned

Oct 21, 2024

Last updated

Oct 21, 2024By the provider in NPPES

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1265253520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 CUMBERLAND ST E",
            "city": "COWAN",
            "state": "TN",
            "postal_code": "373183265",
            "telephone_number": "256-505-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 GALLATIN ST SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014510",
            "telephone_number": "938-902-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "TRACY",
        "middle_name": "T.",
        "credential": "MA, LPT, LSPE",
        "sole_proprietor": "NO",
        "sex": "U",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TN",
            "license": "11784",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AL",
            "license": "1185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichole Turnbow Heidelbach, PSYD, LLC
• Erica Nicholls, CRNA
• Matthew David Nicholls, M.D.
• Mallory Rose Nichols, DPT
• Meagan Nicole Nichols, OTR/L
• John Richard Nicholson III, M.D.
• Nickes Medical Supply, LLC
• Kewin Nielsen, DPT
• Brieanna Nielson
• Carissa Niemann, C.R.N.P.

• Clinical Child & Adolescent Psychologist in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Clinical Child & Adolescent Psychologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.