Tracy Ennis, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

123 Dixon Rd
Queensbury, NY 12804-2133

Phone

(518) 798-2088

Fax

(518) 798-2088

NPI assigned

Mar 27, 2013

Last updated

Jan 2, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

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.

• Adirondack Cross Roads Psychology PLLC

  • Clinical Psychologist
  • Queensbury, NY
  • NPI 1528378692
  NPD (past)

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388620800000",
    "number": "1699017723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 DIXON RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128042133",
            "telephone_number": "518-798-2088",
            "fax_number": "518-798-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 DIXON RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128042133",
            "telephone_number": "518-798-2088",
            "fax_number": "518-798-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "TRACY",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2014-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emerging Vision (sterlingoptical)
• Kathleen Mary Emerson, FNP
• Empire Vision Center Inc (Empire Vision Center)
• Lester John Engelbrecht, LMHC
• Emily Rose Ennis, MT-BC
• Bridget Epiphanie, CLC, PCD
• Equilibrium Psychotherapy Services LCSW PLLC
• Schadique Escoffery
• Patrick J Esmond, DDS
• John A Esper, M.D.

• Mental Health Counselor in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.