Tracie Wells, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P1608120 Issued in AR

Practice address

1615 Martin Luther King Blvd
Malvern, AR 72104

Phone

(501) 624-7111

Fax

(501) 620-5109

NPI assigned

Nov 26, 2012

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

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Conway Counseling and Psychological Services PLLCGroup PAC ID 4183933781, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Conway Counseling & Psychological Services, PLLC

  • Professional Counselor
  • Conway, AR
  • NPI 1528454139
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1295079622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WELLNESS WAY",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136478",
            "telephone_number": "501-624-7111",
            "fax_number": "501-620-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 MARTIN LUTHER KING BLVD",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "72104",
            "telephone_number": "501-624-7111",
            "fax_number": "501-620-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "TRACIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P1608120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Watson, CCMA-CHC
• Lawrence Watson
• Taylor C. Watt, PHARM.D.
• We Speak Therapy LLC
• Sheryl Lynn Welch
• Dillon R Wester
• Bruce Allen White, M.D.
• Fawnda White, M.S., CCC-SLP
• Phillip White Jr., RECOVERY ASSISTANT
• Amy Elizabeth Whitworth, OTR

• Mental Health Counselor in Malvern, AR
• Providers in Malvern, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.