Individual provider Active NPI

Tracey M Lickfelt, LMHC

  • Mental Health Counselor
  • Richmond, IN
National Provider Identifier
1770672206
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39001453A Issued in IN
Practice address
831 Dillon Dr
Richmond, IN 47374-8048
Phone
(765) 983-8000
Fax
(765) 983-8609
NPI assigned
Oct 12, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Mental Health Counselor 101YM0800X 39001453A IN Primary
Clinical Social Worker 1041C0700X 39001453A IN

Addresses

Primary practice location

831 Dillon Dr
Richmond, IN 47374-8048

Mailing address

PO Box 487
Richmond, IN 47375-0487
Phone (765) 983-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20240227003207 IN Practitioner - Mental Health Counselor 6204271471 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Indiana, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Centerstone of Indiana, Inc. Current Accepting new patients

Locations

645 S Rogers St
Bloomington, IN 47403
Phone (812) 339-1691

809 W 1st St
Bloomington, IN 47403

720 N Marr Rd
Columbus, IN 47201
Phone (812) 314-3400

1644 Fry Rd
Greenwood, IN 46142
Phone (317) 788-7733

1713 E 10th St
Jeffersonvlle, IN 47130
Phone (812) 258-0310

2426 S English Dr
Lexington, IN 47138
Phone (812) 949-4377

3008 Bevcher Dr
Madison, IN 47250
Phone (812) 265-1918

1156 Old State Road 46
Nashville, IN 47448
Phone (812) 988-2258

831 Dillon Dr
Richmond, IN 47374
Phone (765) 983-8000

1092 W Community Way
Scottsburg, IN 47170
Phone (812) 414-1520

1443 Corporate Way
Seymour, IN 47274
Phone (812) 522-4341

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1770672206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 487",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473750487",
            "telephone_number": "765-983-8000",
            "fax_number": "765-983-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 DILLON DR",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473748048",
            "telephone_number": "765-983-8000",
            "fax_number": "765-983-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICKFELT",
        "first_name": "TRACEY",
        "middle_name": "M",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-07-21",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001453A",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "39001453A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

Verify at the official NPI Registry.