Individual provider Active NPI

Traci Lynn Wheeler

  • Mental Health Counselor
  • Port Huron, MI
National Provider Identifier
1437858776
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6451022756 Issued in MI
Practice address
3115 Lapeer Rd
Port Huron, MI 48060-7309
Phone
(810) 672-6417
NPI assigned
Feb 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6451022756 MI Primary

Addresses

Primary practice location

3115 Lapeer Rd
Port Huron, MI 48060-7309

Mailing address

365 S Townline Rd
Sandusky, MI 48471-9723
Phone (810) 837-1613

Other practice location 1

520 Superior St
Port Huron, MI 48060-3838
Phone (810) 984-4202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260402003534 MI Practitioner - Mental Health Counselor 9537644919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

365 S Townline Rd
Sandusky, MI 48471-9723

520 Superior St
Port Huron, MI 48060-3838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6451022756MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Evolve Counseling Services, LLC CurrentSince Mar 5, 2023 Accepting new patients
Professional Counseling Center,P.C. Past Accepting new patients

Organizations & group practices 2

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1437858776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 S TOWNLINE RD",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484719723",
            "telephone_number": "810-837-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 LAPEER RD",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480607309",
            "telephone_number": "810-672-6417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 Superior St",
            "address_purpose": "LOCATION",
            "city": "Port Huron",
            "state": "MI",
            "postal_code": "480603838",
            "country_code": "US",
            "telephone_number": "810-984-4202",
            "fax_number": "810-984-8896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "TRACI",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451022756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.