Tracy Nibo

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ACSW 72937 Issued in CA

Practice address

900 W Temple St
Los Angeles, CA 90012-4457

Phone

(310) 484-4177

NPI assigned

Jun 22, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Community Wellness Group

  • Mental Health Counselor
  • Inglewood, CA
  • NPI 1861347817
  NPD Authorized official
• Eye4Peace Community Services Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Inglewood, CA
  • NPI 1255025862
  NPD Authorized official
• Eye4Peace LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1578274379
  NPD Authorized official

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1750763108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W TEMPLE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900124457",
            "telephone_number": "310-484-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W TEMPLE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900124457",
            "telephone_number": "310-484-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIBO",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ACSW 72937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yasi Nia
• Daniel Niacan
• Rebecca Niamtu, CMT 74122
• Amir Niazmand
• Preston Charles Nibley
• Anca Rodica Nica, D.D.S.
• Jocelyn Nicanor Jimenez
• Kathleen Anne Elevazo Nicanor, PHARMD, RPH
• Pearl J Nicassio
• Perry Michael Nicassio, PHD

• Mental Health Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.