Individual provider Active NPI

Tracy A Corwin, LADCP

  • Addiction (Substance Use Disorder) Counselor
  • Elko, NV
National Provider Identifier
1417627852
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
06913-PC Issued in NV
Practice address
215 Bluffs Ave Ste 200
Elko, NV 89801-2465
Phone
(775) 777-8477
NPI assigned
Sep 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 06913-PC NV Primary

Addresses

Primary practice location

215 Bluffs Ave Ste 200
Elko, NV 89801-2465

Mailing address

215 Bluffs Ave Ste 200
Elko, NV 89801-2465
Phone (775) 777-8477

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

State licenses

LicenseStateTypeSpecialty
06913-PCNVMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1417627852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 BLUFFS AVE STE 200",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012465",
            "telephone_number": "775-777-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 BLUFFS AVE STE 200",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012465",
            "telephone_number": "775-777-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORWIN",
        "first_name": "TRACY",
        "middle_name": "A",
        "credential": "LADCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "06913-PC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.