Active NPI
Traci McGough, ED.S, NCSP
- School Psychologist
- West Melbourne, FL
National Provider Identifier
1669878211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- SS1127
- Practice address
- 245 McClain Dr
West Melbourne, FL 32904-5105 - Phone
- (321) 543-8048
- NPI assigned
- Nov 10, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | SS1127 | FL | Primary |
Addresses
Primary practice location
245 McClain Dr
West Melbourne, FL 32904-5105
Mailing address
245 McClain Dr
West Melbourne, FL 32904-5105
Phone (321) 543-8048
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 |
|---|---|---|---|
| SS1127 | FL | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415577600000",
"number": "1669878211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 MCCLAIN DR",
"city": "WEST MELBOURNE",
"state": "FL",
"postal_code": "329045105",
"telephone_number": "321-543-8048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 MCCLAIN DR",
"city": "WEST MELBOURNE",
"state": "FL",
"postal_code": "329045105",
"telephone_number": "321-543-8048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGOUGH",
"first_name": "TRACI",
"credential": "ED.S, NCSP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-11-10",
"last_updated": "2014-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "FL",
"license": "SS1127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.