Tracy Dawn Fazzone, M.A., LPC, RPT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

74588 Issued in TX

Practice address

1302 W Blanco Rd
San Antonio, TX 78232-1014

Phone

(210) 861-3161

NPI assigned

Sep 5, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

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.

• The Ecumenical Center for Religion and Health

  • Counselor
  • San Antonio, TX
  • NPI 1720147093
  NPD (past)

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1518516111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 FAWN BLF",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782481579",
            "telephone_number": "210-861-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 W BLANCO RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321014",
            "telephone_number": "210-861-3161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8310 Ewing Halsell Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293715",
            "country_code": "US",
            "telephone_number": "210-616-0885",
            "fax_number": "210-616-0845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAZZONE",
        "first_name": "TRACY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "M.A., LPC, RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose A Faz Jr.
• Roosevelt Faz
• Sayed M. Fazely
• Joanne C Fazio-Gosser, RPH
• Corinne Fazio
• Regina Marie Fearmonti, M.D.
• Aubrey Fearn, DC, MS
• Annette Renee Fears, OTR/L
• Vanessa Fears
• Anthony Jose Febres Aldana, MD

• Professional Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.