Tracey G. Henley, PSY D

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY6020 Issued in FL

Practice address

4720 Cleveland Heights Blvd Ste 105
Lakeland, FL 33813-2244

Phone

(863) 701-9202

Fax

(863) 701-9292

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

No

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychological and Neurobehavioral Services P aGroup PAC ID 5991720054, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Psychological and Neurobehavioral Services P a

  • Clinical Neuropsychologist
  • Lakeland, FL
  • NPI 1528127081
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1528129038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 CLEVELAND HEIGHTS BLVD STE 105",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132244",
            "telephone_number": "863-701-9202",
            "fax_number": "863-701-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 CLEVELAND HEIGHTS BLVD STE 105",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132244",
            "telephone_number": "863-701-9202",
            "fax_number": "863-701-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENLEY",
        "first_name": "TRACEY",
        "middle_name": "G.",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY6020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikayla Hendrickson
• Debbie Hendry, AU.D.
• Jill R Hendry, ARNP
• Christine Marie Henkelman, PHYSICAL THERAPIST
• Julian L Henley, MD
• Vivian Margareth Hennings, COTA
• Bret D. Henricks, M. D.
• Benjamin Henry
• Louise Marie Henry, LMHC
• Margaret S Henry, LMT

• Clinical Neuropsychologist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.