Individual provider Active NPI

Tracy Milstead, LPC

  • Mental Health Counselor
  • Kingsland, GA
National Provider Identifier
1710446570
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC011595 Issued in GA
Practice address
207 Winona Way
Kingsland, GA 31548-6581
Phone
(904) 310-4446
Fax
(888) 919-3114
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC011595 GA
Professional Counselor 101YP2500X APC005888 GA
Mental Health Counselor 101YM0800X LPC011595 GA Primary

Addresses

Primary practice location

207 Winona Way
Kingsland, GA 31548-6581

Mailing address

207 Winona Way
Kingsland, GA 31548-6581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231227001692 GA Practitioner - Mental Health Counselor 9436509890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

207 Winona Way
Kingsland, GA 31548-6581
Phone (904) 310-4446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC011595GAMDMental Health Counselor
APC005888GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tracy Milstead, LLC Mental Health CurrentSince Jan 1, 2024 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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1710446570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 WINONA WAY",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 WINONA WAY",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486581",
            "telephone_number": "904-310-4446",
            "fax_number": "888-919-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILSTEAD",
        "first_name": "TRACY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC011595",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC005888",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC011595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsland, GA

Sources for this page

Verify at the official NPI Registry.