Tracy Wiesneske

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

325 Pine St Ste B
Mount Vernon, WA 98273-5929

Phone

(206) 530-1286

NPI assigned

Jun 22, 2012

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Authentic Vibrancy Company PLLC

  • Mental Health Counselor
  • Mount Vernon, WA
  • NPI 1245116680
  Medicare reassignment NPD Authorized official
• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1841553971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 PINE ST STE B",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PINE ST STE B",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735929",
            "telephone_number": "206-530-1286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESNESKE",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2022-12-05",
        "certification_date": "2022-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1841553971",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://authenticvibrancy.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "325 Pine St Ste B",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982735929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mark Anthony White Jr., LMP
• Whitney Forsythe DMD & Nick Forsythe DMD PLLC
• Whiton & Register PLLC
• Michal Anne Whiton, M.D.
• Jocelyn Elaine Wicks, M.S.
• Jessica Brie Wilcox, FNP
• Rebecca Ann Wilhelm, ND
• Savannah Nicole Wilkinson, DO
• Debbie Fox Wilkison
• Brandi Lynn Williams

• Mental Health Counselor in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.