Active NPI
Tracy E. Crain, LPC-S, LCDC
- Mental Health Counselor
- Southlake, TX
National Provider Identifier
1740444926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC 19459
- Practice address
- 305 Miron Drive
Southlake, TX 76092 - Phone
- (682) 233-2882
- Fax
- (682) 292-1380
- NPI assigned
- Jul 16, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCDC 9238 | TX | |
| Professional Counselor | 101YP2500X | LPC 19459 | TX | |
| Mental Health Counselor | 101YM0800X | LPC 19459 | TX | Primary |
Addresses
Primary practice location
305 Miron Drive
Southlake, TX 76092
Mailing address
217 West Mill Valley Drive
Colleyville, TX 76034
Phone (817) 937-5504
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 162022101 | Medicaid | TX |
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 |
|---|---|---|---|
| LCDC 9238 | TX | MD | Addiction (Substance Use Disorder) Counselor |
| LPC 19459 | TX | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Texas Addiction Counseling & Education, Inc. | Past | 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.
-
- Multi-Specialty Clinic/Center
- Arlington, TX
- NPI 1285801589
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665100800000",
"number": "1740444926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 WEST MILL VALLEY DRIVE",
"city": "COLLEYVILLE",
"state": "TX",
"postal_code": "76034",
"telephone_number": "817-937-5504",
"fax_number": "682-292-1380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 MIRON DRIVE",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "76092",
"telephone_number": "682-233-2882",
"fax_number": "682-292-1380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAIN",
"first_name": "TRACY",
"middle_name": "E.",
"name_prefix": "Ms.",
"credential": "LPC-S, LCDC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-16",
"last_updated": "2022-10-07",
"certification_date": "2022-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "LCDC 9238",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "LPC 19459",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "LPC 19459",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "162022101",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.