Individual provider Active NPI

Tracy Hutchinson, PH.D., LMHC

  • Mental Health Counselor
  • Fort Myers, FL
National Provider Identifier
1558736918
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13596 Issued in FL
Practice address
1342 Colonial Blvd Ste F41A
Fort Myers, FL 33907-1030
Phone
(239) 931-4444
NPI assigned
Dec 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 13596 FL Primary

Addresses

Primary practice location

1342 Colonial Blvd Ste F41A
Fort Myers, FL 33907-1030

Mailing address

1342 Colonial Blvd Ste F41A
Fort Myers, FL 33907-1030
Phone (239) 931-4444

Other identifiers 1

IdentifierTypeStateIssuer
12250153OtherCAQH

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
13596FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1558736918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1342 COLONIAL BLVD STE F41A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071030",
            "telephone_number": "239-931-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1342 COLONIAL BLVD STE F41A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071030",
            "telephone_number": "239-931-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHINSON",
        "first_name": "TRACY",
        "credential": "PH.D., LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-09",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "13596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12250153",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; 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.