Active NPI
Tracy Laurel Coleman, LPC
- Professional Counselor
- Jacksonville, AR
National Provider Identifier
1578828109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- P1702246
- Practice address
- 2126 N 1St Street
Suite F
Jacksonville, AR 72076-2868 - Phone
- (501) 982-5000
- Fax
- (501) 982-5007
- NPI assigned
- Jul 10, 2012
- Last updated
- Oct 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | P1702246 | AR | Primary |
| Case Manager/Care Coordinator | 171M00000X | NU |
Addresses
Primary practice location
2126 N 1St Street
Suite F
Jacksonville, AR 72076-2868
Mailing address
1815 Pleasant Grove Road
Jonesboro, AR 72405-7870
Phone (670) 933-6886
Other names 1
- Tracy Laurel Fitch
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P1702246 | AR | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alan Hahn LPC PLLC | Past | Accepting new patients | |
| New Beginings Behavioral Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Counselor
- Conway, AR
- NPI 1588282198
-
- Community/Behavioral Health Agency
- Little Rock, AR
- NPI 1699215392
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602547200000",
"number": "1578828109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 PLEASANT GROVE ROAD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724057870",
"telephone_number": "670-933-6886",
"fax_number": "870-933-9395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2126 N 1ST STREET",
"address_2": "SUITE F",
"city": "JACKSONVILLE",
"state": "AR",
"postal_code": "720762868",
"telephone_number": "501-982-5000",
"fax_number": "501-982-5007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "TRACY",
"middle_name": "LAUREL",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-10",
"last_updated": "2020-10-13",
"certification_date": "2020-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P1702246",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TRACY",
"last_name": "FITCH",
"middle_name": "LAUREL",
"credential": "LPC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Jacksonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.