Tracy Renee Pritzl, PSY.D, BCBA-D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2825-27 Issued in WI

Practice address

3636 N 124TH St
Suite 200
Wauwatosa, WI 53222

Phone

(414) 476-9755

Fax

(414) 476-3413

NPI assigned

Sep 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Tracy Renee Brey 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": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1427243369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 N 124TH ST",
            "address_2": "SUITE 200",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53222",
            "telephone_number": "414-476-9755",
            "fax_number": "414-476-3413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 N 124TH ST",
            "address_2": "SUITE 200",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53222",
            "telephone_number": "414-476-9755",
            "fax_number": "414-476-3413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRITZL",
        "first_name": "TRACY",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PSY.D, BCBA-D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "44-140",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2825-27",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427243369",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "BREY",
            "middle_name": "RENEE",
            "prefix": "DR.",
            "credential": "PSY.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Psychologist in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.