Individual provider Active NPI

Tracia Hughes Jungkurth, PHD, LPC, LMHC

  • Mental Health Counselor
  • Mount Juliet, TN
National Provider Identifier
1558404178
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1827 Issued in TN
Practice address
313B W Division St
Mount Juliet, TN 37122-3207
Phone
(615) 636-7414
Fax
(866) 799-4512
NPI assigned
Feb 14, 2007
Last updated
Jan 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1827 TN Primary
Mental Health Counselor 101YM0800X MH9523 FL

Addresses

Primary practice location

313B W Division St
Mount Juliet, TN 37122-3207

Mailing address

PO Box 555
Mount Juliet, TN 37121-0555
Phone (615) 636-7414

Other identifiers 2

IdentifierTypeStateIssuer
MH9523OtherFLMENTAL HEALTH COUNSELOR
1827OtherTNLPC MHSP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MH9523FLMDMental Health Counselor
1827TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher Ministries, Inc. Mental Health Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1558404178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371210555",
            "telephone_number": "615-636-7414",
            "fax_number": "866-799-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313B W DIVISION ST",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371223207",
            "telephone_number": "615-636-7414",
            "fax_number": "866-799-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNGKURTH",
        "first_name": "TRACIA",
        "middle_name": "HUGHES",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "1827",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9523",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH COUNSELOR",
            "identifier": "MH9523",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC MHSP",
            "identifier": "1827",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Juliet, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; 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.