Lifetrack Counseling LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

70313 Issued in TX

Legal business name

LIFETRACK COUNSELING LLC

Practice address

904 Granger Dr
Allen, TX 75013-1102

Phone

(972) 977-0203

NPI assigned

Aug 22, 2017

Last updated

Jun 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel Wichman, MS, LPC, LCDCNPI 1326406455

Title

Member Manager

Phone

(972) 977-0203

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Wichman, LPC

  • Mental Health Counselor
  • Allen, TX
  • NPI 1326406455
  NPD Authorized official

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1548786478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 GRANGER DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750131102",
            "telephone_number": "972-977-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 GRANGER DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750131102",
            "telephone_number": "972-977-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETRACK COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-22",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "WICHMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "972-977-0203",
        "authorized_official_credential": "MS, LPC, LCDC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TX",
            "license": "70313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.

Verify at the official NPI Registry.