Active NPI
Tracie S. Lee, PHD
- Clinical Psychologist
- Bronx, NY
National Provider Identifier
1306653456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 026829
- Practice address
- 1400 Pelham Parkway South
Building 1, RM 146
Bronx, NY 10461 - Phone
- (718) 918-3658
- NPI assigned
- Dec 12, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 026829 | NY | Primary |
Addresses
Primary practice location
1400 Pelham Parkway South
Building 1, RM 146
Bronx, NY 10461
Mailing address
235 E 88TH St Apt 3B
New York, NY 10128-3370
Phone (613) 407-7234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250506002065 | NY | Order and Referring Only - Clinical Psychologist | 2769909423 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733961600000",
"number": "1306653456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 E 88TH ST APT 3B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101283370",
"telephone_number": "613-407-7234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 PELHAM PARKWAY SOUTH",
"address_2": "BUILDING 1, RM 146",
"city": "BRONX",
"state": "NY",
"postal_code": "10461",
"telephone_number": "718-918-3658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "TRACIE",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-12",
"last_updated": "2024-12-12",
"certification_date": "2024-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "026829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.