Active NPI
Tracy Lee Eagle, MS
- Professional Counselor
- Saginaw, MI
National Provider Identifier
1689922585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 4151 Shrestha Drive
Ste D
Saginaw, MI 48603-2190 - Phone
- (989) 220-3060
- Fax
- (989) 790-5027
- NPI assigned
- Aug 27, 2012
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
4151 Shrestha Drive
Ste D
Saginaw, MI 48603-2190
Mailing address
96 E Gordonville Rd
Midland, MI 48640-8384
Phone (989) 790-3366
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ON80300 | Other | MI | MEDICARE |
Other names 1
- Mrs. Tracy Lee Gallatin
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
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maple Leaf Counseling Services LLC | Counselor | Past | Accepting new patients |
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": "1346025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1689922585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "96 E GORDONVILLE RD",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486408384",
"telephone_number": "989-790-3366",
"fax_number": "989-790-5027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4151 SHRESTHA DRIVE",
"address_2": "STE D",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486032190",
"telephone_number": "989-220-3060",
"fax_number": "989-790-5027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAGLE",
"first_name": "TRACY",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-27",
"last_updated": "2024-05-30",
"certification_date": "2024-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "ON80300",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TRACY",
"last_name": "GALLATIN",
"middle_name": "LEE",
"prefix": "MRS.",
"credential": "BS, FAODP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Saginaw, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.