Active NPI
Tracy Goza, PHD
- Professional Counselor
- Tyler, TX
National Provider Identifier
1447655121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 63009
- Practice address
- 17521 Highway 69 S BLDG II
Tyler, TX 75703-5594 - Phone
- (281) 513-6041
- NPI assigned
- Oct 23, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 63009 | TX | Primary |
Addresses
Primary practice location
17521 Highway 69 S BLDG II
Tyler, TX 75703-5594
Mailing address
108 Lake Lou Ella Dr
Bullard, TX 75757-5499
Phone (972) 740-7680
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
| License | State | Type | Specialty |
|---|---|---|---|
| 63009 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671321600000",
"number": "1447655121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 LAKE LOU ELLA DR",
"city": "BULLARD",
"state": "TX",
"postal_code": "757575499",
"telephone_number": "972-740-7680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17521 HIGHWAY 69 S BLDG II",
"city": "TYLER",
"state": "TX",
"postal_code": "757035594",
"telephone_number": "281-513-6041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOZA",
"first_name": "TRACY",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-23",
"last_updated": "2022-12-18",
"certification_date": "2022-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "63009",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.