Active NPI
Amanda Tracy
- Counselor
- Laramie, WY
National Provider Identifier
1447890983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- PPP-1401
- Practice address
- 4989 N 3Rd St
Laramie, WY 82072-9548 - Phone
- (307) 745-8997
- NPI assigned
- Jan 13, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Counselor | 101Y00000X | PPP-1401 | WY | Primary |
Addresses
Primary practice location
4989 N 3Rd St
Laramie, WY 82072-9548
Mailing address
4989 N 3Rd St
Laramie, WY 82072-9548
Phone (307) 745-8997
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
| License | State | Type | Specialty |
|---|---|---|---|
| PPP-1401 | WY | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cathedral Home for Children | Counselor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatric Residential Treatment Facility
- Laramie, WY
- NPI 1003301904
Counselor
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689292800000",
"number": "1447890983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4989 N 3RD ST",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820729548",
"telephone_number": "307-745-8997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4989 N 3RD ST",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820729548",
"telephone_number": "307-745-8997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRACY",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-13",
"last_updated": "2023-07-14",
"certification_date": "2023-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WY",
"license": "PPP-1401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laramie, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.