Tracey Dineen-Hutchins, LPC, LADC

Individual provider Active NPI Professional Counselor · Niantic, CT

NPI 1881965440 · NPPES record last updated Oct 9, 2018

Key facts

NPI
1881965440
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
000714 (CT)
Practice address
22 Pennslyvania Ave
Suite 8
Niantic, CT 06357-3231
Phone
(860) 861-7047
NPI assigned
Jan 13, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
000713CTMDMarriage & Family Therapist
000714CTMDPodiatrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 000713 CT
Professional Counselor 101YP2500X 000714 CT Yes

Addresses

Primary practice location

22 Pennslyvania Ave
Suite 8
Niantic, CT 06357-3231

Mailing address

972 Ekonk Hill Rd
Voluntown, CT 06384-1004

Other providers in Niantic, CT

All providers in Niantic, CT · Professional Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.