Individual provider Active NPI

Tracie Leigh Kulakowski, LMFT

  • Marriage & Family Therapist
  • Carlsbad, CA
National Provider Identifier
1841995750
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
142786 Issued in CA
Practice address
785 Grand Ave Ste 212
Carlsbad, CA 92008-2371
Phone
(760) 453-7175
NPI assigned
Mar 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 142786 CA Primary

Addresses

Primary practice location

785 Grand Ave Ste 212
Carlsbad, CA 92008-2371

Mailing address

785 Grand Ave Ste 212
Carlsbad, CA 92008-2371
Phone (760) 453-7175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240412003497 CA Practitioner - Marriage and Family Therapist 3971942715 Practice locations: Carlsbad, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Carlsbad, CA 92009
Phone (760) 705-4208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
142786CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1841995750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 GRAND AVE STE 212",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920082371",
            "telephone_number": "760-453-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 GRAND AVE STE 212",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920082371",
            "telephone_number": "760-453-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULAKOWSKI",
        "first_name": "TRACIE",
        "middle_name": "LEIGH",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-31",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "142786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

Verify at the official NPI Registry.