Traci Fuglestad

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

SW26623 Issued in FL

Practice address

84 W Lowder St
Macclenny, FL 32063-2638

Phone

(352) 374-5600

NPI assigned

Oct 1, 2026

Last updated

Oct 1, 2026By the provider in NPPES

Sex

Unspecified or another gender identity

Sole proprietor

Yes

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

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

{
    "created_epoch": "1790812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1265346696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 SW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 W LOWDER ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632638",
            "telephone_number": "352-374-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUGLESTAD",
        "first_name": "TRACI",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2026-10-01",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW26623",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW26623",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Coast Imaging, LLC (Select Diagnostics)
• Florida Department of Children and Families (Northeast Florida State Hospital)
• Florida Department of Children and Families (NortheastFloridaStateHospitalCommunityBehavioralHealthcareServices)
• Florida Department of Health (Baker County Health Department)
• Foundations: Speech, Language and Learning Services
• Mary Martha Futch, O.D.
• George C. Weeks, DDS PA
• Natalie Gerido
• Kallie Rae Gibson, PT
• Lakeyta Nacole Givens

• Mental Health Counselor in Macclenny, FL
• Providers in Macclenny, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.