Individual provider Active NPI

Tracy Lynn Allen, LPCC-S

  • Counselor
  • Bowling Green, OH
National Provider Identifier
1336651975
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C1700281 Issued in OH
Practice address
1234 Ridgewood Dr Ste C
Bowling Green, OH 43402-2695
Phone
(419) 494-7141
NPI assigned
Nov 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C1700281 OH Primary

Addresses

Primary practice location

1234 Ridgewood Dr Ste C
Bowling Green, OH 43402-2695

Mailing address

1234 Ridgewood Dr Ste C
Bowling Green, OH 43402-2695
Phone (419) 494-7141

Other practice location 1

6605 W Central Ave
Toledo, OH 43617-1000
Phone (419) 841-7701

Other names 1

  • Tracy L Freese Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20240411002720 OH Practitioner - Mental Health Counselor 7315386232 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C1700281OHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Presence of Mind Counseling CurrentSince Jul 4, 2024 Accepting new patients
Viaquest Psychiatric & Behavioral Solutions LLC PastSince Jun 30, 2024 Accepting new patients

Locations

1234 Ridgewood Dr
Ste C
Bowling Green, OH 43402
Phone (419) 408-5533

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1336651975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 RIDGEWOOD DR STE C",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022695",
            "telephone_number": "419-494-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 RIDGEWOOD DR STE C",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022695",
            "telephone_number": "419-494-7141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6605 W Central Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436171000",
            "country_code": "US",
            "telephone_number": "419-841-7701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-03",
        "last_updated": "2024-06-28",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C1700281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "FREESE",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bowling Green, OH

Sources for this page

Verify at the official NPI Registry.