Tracy Ann Flynn, M.S. ED., LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7554 Issued in NC

Practice address

1725 S Main St
Suite 202
Wake Forest, NC 27587-5012

Phone

(919) 556-6501

Fax

(919) 556-4933

NPI assigned

Feb 3, 2010

Last updated

Feb 3, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Tracy Ann Millspaugh Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Monarch

  • Community/Behavioral Health Agency
  • Albemarle, NC
  • NPI 1801116405
  Medicare reassignment NPD
• Monarch

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1073267126
  NPD
• Monarch

  • Community/Behavioral Health Agency
  • Albemarle, NC
  • NPI 1972644334
  NPD

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1871825794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 S MAIN ST",
            "address_2": "SUITE 202",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275875012",
            "telephone_number": "919-556-6501",
            "fax_number": "919-556-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 S MAIN ST",
            "address_2": "SUITE 202",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275875012",
            "telephone_number": "919-556-6501",
            "fax_number": "919-556-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.S. ED., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-03",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "7554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "MILLSPAUGH",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "M.S. ED.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Bridget A Flynn, LMFT, ATR
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• Mackenzie Forman, CCC-SLP
• Shaunaci Simone Cage Fornes, RN,RNC-NIC, CLC

• Mental Health Counselor in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.