NPIMap

Organization Active NPI

Tracy Davis, LMFT, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minnetonka, MN
National Provider Identifier
1497578439
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
TRACY DAVIS, LMFT, LLC
Practice address
11812 Wayzata Blvd Ste 200B
Minnetonka, MN 55305-2012
Phone
(612) 293-5823
NPI assigned
Nov 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Authorized official

Name
Tracy Davis, LMFTNPI 1023531480
Title
Owner
Phone
(612) 293-5823

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

11812 Wayzata Blvd Ste 200B
Minnetonka, MN 55305-2012

Mailing address

11812 Wayzata Blvd Ste 200B
Minnetonka, MN 55305-2012
Phone (612) 293-5823

Other names 1

  • Willow Creek Counseling MN Doing business as

National Provider Directory

National Provider Directory

Locations

11812 Wayzata Blvd
Ste 200B
Minnetonka, MN 55305
Phone (612) 293-5823

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1497578439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11812 WAYZATA BLVD STE 200B",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052012",
            "telephone_number": "612-293-5823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11812 WAYZATA BLVD STE 200B",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052012",
            "telephone_number": "612-293-5823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY DAVIS, LMFT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-293-5823",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow Creek Counseling MN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.