Traci Moss Hedrick, LAC, CCDP, CCGC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LAC 1122 Issued in LA

Practice address

4105 Kirkman St
Lake Charles, LA 70607-4603

Phone

(337) 475-8022

Fax

(337) 475-8054

NPI assigned

May 30, 2007

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

Other names 1

• Miss Traci Moss Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Imperial Calcasieu Human Services Authority

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lake Charles, LA
  • NPI 1952449118
  NPD (past)

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1326249970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 KIRKMAN ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706074603",
            "telephone_number": "337-475-8022",
            "fax_number": "337-475-8054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 KIRKMAN ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706074603",
            "telephone_number": "337-475-8022",
            "fax_number": "337-475-8054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDRICK",
        "first_name": "TRACI",
        "middle_name": "MOSS",
        "credential": "LAC, CCDP, CCGC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "LAC 1122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "MOSS",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicholas Blaine Hebert, DPM
• Patrick Hebert, LCSW #10194
• William Gerry Hebert, M.D.
• Andrew Michael Hedlesky
• Sophie Hedlesky, PT
• Heinen Family Medicine
• Chad N Heinen, M.D.
• Christina Hensgens Heinen, SLP
• David P Heinen, MD
• Helping Hands Counseling, Inc

• Addiction (Substance Use Disorder) Counselor in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Addiction (Substance Use Disorder) Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.