Individual provider Active NPI

Tracy Matcham, PHD, LPC

  • Counselor
  • Denison, TX
National Provider Identifier
1679990410
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1105 Memorial Dr Ste 202
Denison, TX 75020-2043
Phone
(903) 337-0343
NPI assigned
Mar 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

1105 Memorial Dr Ste 202
Denison, TX 75020-2043

Mailing address

1105 Memorial Dr Ste 202
Denison, TX 75020-2043
Phone (903) 337-0343

Other practice location 1

1312 N 1st Ave
Durant, OK 74701-2810
Phone (580) 920-2069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240103002663 OK Practitioner - Mental Health Counselor 5496105470 Reassigns benefits to 1 organization
I20251112002682 TX Practitioner - Mental Health Counselor 5496105470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Psychological Development IncGroup PAC ID 5395929384, 28 clinicians

Practice addresses (Care Compare)

1105 Memorial Dr
Suite 202
Denison, TX 75020-2043
Phone (903) 337-0343

1312 N 1St Ave
Durant, OK 74701-2810
Phone (580) 920-2069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Psychological Development, Inc. Counselor CurrentSince Jan 1, 2024 Accepting new patients

Locations

1312 N 1st Ave
Durant, OK 74701
Phone (580) 920-2069

106 S 3rd St
McAlester, OK 74501
Phone (918) 421-8880

1105 Memorial Dr
Ste 202
Denison, TX 75020
Phone (903) 337-0343

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1679990410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 MEMORIAL DR STE 202",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750202043",
            "telephone_number": "903-337-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 MEMORIAL DR STE 202",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750202043",
            "telephone_number": "903-337-0343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1312 N 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Durant",
            "state": "OK",
            "postal_code": "747012810",
            "country_code": "US",
            "telephone_number": "580-920-2069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATCHAM",
        "first_name": "TRACY",
        "credential": "PHD, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-18",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, TX

Sources for this page

Verify at the official NPI Registry.