Kelley-Beth Tracy, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5202008394 Issued in MI

Practice address

3310 W Commerce Rd
Milford, MI 48380-3100

Phone

(248) 685-1400

NPI assigned

Dec 11, 2023

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

• Kelley-Beth Peters Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1346017266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 HARRISON ST APT 103",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181068",
            "telephone_number": "734-395-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 W COMMERCE RD",
            "city": "MILFORD",
            "state": "MI",
            "postal_code": "483803100",
            "telephone_number": "248-685-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "KELLEY-BETH",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MI",
            "license": "5202008394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY-BETH",
            "last_name": "PETERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gary Lynn Thomas, LMSW,ACSW
• Heather Susan Thomas, LPC
• Rosa Maria Thomas, MA. LLP.
• Makenzie Thomson, LLPC
• Township of Milford
• Elizabeth Jean Treger, LPC
• Urgent Care of Milford PLLC
• Ifiok Nsima Usen, NP
• Rimantas O Vaitas, DDS
• Valley Home Health Care, LLC

• Occupational Therapy Assistant in Milford, MI
• Providers in Milford, MI by specialty
• Occupational Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.