Active NPI
Tracie R Edwards
- Professional Counselor
- Flint, MI
National Provider Identifier
1821248865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401011486
- Practice address
- 1110 Eldon Baker Dr
Flint, MI 48507-1923 - Phone
- (810) 213-1803
- Fax
- (810) 744-1306
- NPI assigned
- Sep 26, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401011486 | MI | Primary |
Addresses
Primary practice location
1110 Eldon Baker Dr
Flint, MI 48507-1923
Mailing address
1110 Eldon Baker Dr
Flint, MI 48507-1923
Phone (810) 213-1803
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 |
|---|---|---|---|
| 6401011486 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440374400000",
"number": "1821248865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 ELDON BAKER DR",
"city": "FLINT",
"state": "MI",
"postal_code": "485071923",
"telephone_number": "810-213-1803",
"fax_number": "810-744-1306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 ELDON BAKER DR",
"city": "FLINT",
"state": "MI",
"postal_code": "485071923",
"telephone_number": "810-213-1803",
"fax_number": "810-744-1306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "TRACIE",
"middle_name": "R",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-26",
"last_updated": "2015-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401011486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.