Tracey Elizalde FNP-BC Pmhnp-BC LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

TRACEY ELIZALDE FNP-BC PMHNP-BC LLC

Practice address

812 Toll House Ave
Frederick, MD 21701-4519

Phone

(240) 439-5928

NPI assigned

May 30, 2024

Organization subpart

No

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

Authorized official

Name

Tracey Elizalde, FNP-BC PMHNP-BC

Title

Owner

Phone

(240) 439-5928

Specialties & licenses 1

Addresses

Other names 1

• Open Door Mental Health Doing business as

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1720828320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3072",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217053072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 TOLL HOUSE AVE",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014519",
            "telephone_number": "240-439-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACEY ELIZALDE FNP-BC PMHNP-BC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "ELIZALDE",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-439-5928",
        "authorized_official_credential": "FNP-BC PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Open Door Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nika Toure, LMSW
• Melanie Towe, DMD
• Jane Towers IX, PH.D.
• Kari M Towns, PA
• Yvonne Townsley, MPT
• Amanda Tracey, LCPC
• Heather Nicole Trageser, COTA/L
• Henry Tran
• Neena Tran, LCSW-C
• Tranquility Woods Wellness Center LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Frederick, MD
• Providers in Frederick, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• 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.

Verify at the official NPI Registry.