Tracy Yaeger, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4509 Issued in OH

Practice address

340 S Broadway St
Akron, OH 44308-1529

Phone

(330) 253-3100

Fax

(330) 253-5248

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Portage Path Community Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Akron, OH
  • NPI 1225087802
  NPD (past) Authorized official
• Portage Path Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Akron, OH
  • NPI 1114492147
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1710073796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 S BROADWAY ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081529",
            "telephone_number": "330-253-3100",
            "fax_number": "330-253-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 S BROADWAY ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081529",
            "telephone_number": "330-253-3100",
            "fax_number": "330-253-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAEGER",
        "first_name": "TRACY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "4509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2314561",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000127112",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fangfei Xiao, DO
• Weina Xie, CNP
• Xpedient Transportation, Inc
• Bishal Yadav, MBBS
• Mandeep Kumar Yadav, M.D.
• Jill Elizabeth Yajnik, M.A. CCC-SLP
• Rebecca Yako, LISW
• Keith Yancey
• Michael S Yancey
• John Yanchek

• All providers in Akron, OH
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.