Tracey Crew Johnson, LMHC
Individual provider Active NPI Mental Health Counselor · Enterprise, FL
NPI 1578828281 · NPPES record last updated Sep 13, 2018
Key facts
- NPI
- 1578828281
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- MH11370 (FL)
- Practice address
- 51 Childrens Way
Enterprise, FL 32725-8135 - Phone
- (386) 668-4774
- Fax
- (386) 668-0542
- NPI assigned
- Jul 9, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH11370 | FL | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH11370 | FL | Yes |
Addresses
Primary practice location
51 Childrens Way
Enterprise, FL 32725-8135
Mailing address
51 Childrens Way
Enterprise, FL 32725-8135
Phone (386) 668-4774
Other providers in Enterprise, FL
- Florida United Methodist Children'S Home Inc.
- Florida United Methodist Childrens Home, Inc.
- Florida United Methodist Childrens Home, Inc.
- Sabrina Eileen Green
- Nadine Heusner
- Jennifer Marie Lands
- Cynthia Laughrun
- Corey J Lugo
- Debra M Mahoney
- Diana Monzon
All providers in Enterprise, FL · Mental Health Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.