Tina Louise Bracey, M.A., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

114 South Hill Avenue
South Hill, VA 23970-3240

Phone

(434) 584-9434

Fax

(888) 722-4701

NPI assigned

Apr 3, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Mrs. Tina Louise Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• 6 C'S to Success LLC

  • Counselor
  • La Crosse, VA
  • NPI 1427522606
  NPD

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1497287809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239700367",
            "telephone_number": "434-584-9434",
            "fax_number": "888-722-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 SOUTH HILL AVENUE",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239703240",
            "telephone_number": "434-584-9434",
            "fax_number": "888-722-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACEY",
        "first_name": "TINA",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "M.A., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": "0701008125",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701008125",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701008125",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019022734",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "JOHNSON",
            "middle_name": "LOUISE",
            "prefix": "MRS.",
            "credential": "M.A., LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eric Blackwell
• Mackenzie Jean Blackwell, RDH
• Bailey Lynn Bowen
• Elizabeth Yancey Bowlin, FNP
• Bernita Danica Boyd
• George Breedlove
• Leigh A. Brewster, FNP
• Jessica Nicole Brickers, CRNA
• Christopher K Brown Jr., MD
• Darrell James Brown Jr., MD

• All providers in South Hill, VA
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.