Individual provider Active NPI

Tracy J. Gallegos, B.A., CACIII

  • Addiction (Substance Use Disorder) Counselor
  • Grand Junction, CO
National Provider Identifier
1386965176
Registry record updated Dec 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
ACC.0020787 Issued in CO
Practice address
2708 Patterson Rd
Grand Junction, CO 81506-4031
Phone
(970) 243-9539
Fax
(970) 245-7493
NPI assigned
Jun 16, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X
Addiction (Substance Use Disorder) Counselor 101YA0400X ACC.0020787 CO Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

2708 Patterson Rd
Grand Junction, CO 81506-4031

Mailing address

2708 Patterson Rd
Grand Junction, CO 81506-4031
Phone (970) 243-9539

Other practice location 1

2702 B 1/2 Rd
Grand Junction, CO 81503-2815
Phone (970) 243-9539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
ACC.0020787COMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Enriched Communications, Inc. Mental Health PastSince Mar 3, 2024 Accepting new patients

Organizations & group practices 1

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": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733616000000",
    "number": "1386965176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 PATTERSON RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815064031",
            "telephone_number": "970-243-9539",
            "fax_number": "970-245-7493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 PATTERSON RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815064031",
            "telephone_number": "970-243-9539",
            "fax_number": "970-245-7493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2702 B 1/2 Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815032815",
            "country_code": "US",
            "telephone_number": "970-243-9539",
            "fax_number": "970-245-7493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "TRACY",
        "middle_name": "J.",
        "credential": "B.A., CACIII",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2024-12-08",
        "certification_date": "2024-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACC.0020787",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2024; 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.