Individual provider Active NPI

Tracey E Robert, PH.D.

  • Professional Counselor
  • Fairfield, CT
National Provider Identifier
1396081089
Registry record updated Dec 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
000238 Issued in CT
Practice address
163 Oldfield Rd
Fairfield, CT 06824-6687
Phone
(203) 256-8611
Fax
(203) 254-2242
NPI assigned
Dec 27, 2012
Last updated
Dec 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 000238 CT Primary

Addresses

Primary practice location

163 Oldfield Rd
Fairfield, CT 06824-6687

Mailing address

163 Oldfield Rd
Fairfield, CT 06824-6687
Phone (203) 256-8611

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
000238CTMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356566400000",
    "number": "1396081089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 OLDFIELD RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246687",
            "telephone_number": "203-256-8611",
            "fax_number": "203-254-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 OLDFIELD RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246687",
            "telephone_number": "203-256-8611",
            "fax_number": "203-254-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERT",
        "first_name": "TRACEY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-27",
        "last_updated": "2012-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "000238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; 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.