Active NPI
Tracy Glaze, LMHC
- Counselor
- Gulf Breeze, FL
National Provider Identifier
1720198823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- MH3507
- Practice address
- 1198 Gulf Breeze Pkway
Suite 4
Gulf Breeze, FL 32561 - Phone
- (850) 934-4523
- Fax
- (850) 934-4520
- NPI assigned
- Aug 30, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | MH3507 | FL | Primary |
Addresses
Primary practice location
1198 Gulf Breeze Pkway
Suite 4
Gulf Breeze, FL 32561
Mailing address
1198 Gulf Breeze Pkway
Suite 4
Gulf Breeze, FL 32561
Phone (850) 934-4523
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH3507 | FL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652918400000",
"number": "1720198823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1198 GULF BREEZE PKWAY",
"address_2": "SUITE 4",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "32561",
"telephone_number": "850-934-4523",
"fax_number": "850-934-4520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1198 GULF BREEZE PKWAY",
"address_2": "SUITE 4",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "32561",
"telephone_number": "850-934-4523",
"fax_number": "850-934-4520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLAZE",
"first_name": "TRACY",
"name_prefix": "Mrs.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2022-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "MH3507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulf Breeze, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.