Tracy Kennedy Counseling LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

TRACY KENNEDY COUNSELING LLC

Doing business as

Tracy Kennedy Counseling LLC

Practice address

1142 Highway 71 S Ste C
Mena, AR 71953-8078

Phone

(479) 437-7967

NPI assigned

Oct 14, 2022

Organization subpart

No

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

Authorized official

Name

Tracy KennedyNPI 1619227279

Title

Owner

Phone

(479) 216-4262

Specialties & licenses 2

Addresses

Other names 1

• Tracy Kennedy Counseling LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy Ann Kennedy, LPC

  • Professional Counselor
  • Mena, AR
  • NPI 1619227279
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1891411559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 ALLEN LN",
            "city": "ODEN",
            "state": "AR",
            "postal_code": "719618069",
            "telephone_number": "479-216-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1142 HIGHWAY 71 S STE C",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719538078",
            "telephone_number": "479-437-7967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 DeQueen St",
            "address_purpose": "LOCATION",
            "city": "Oden",
            "state": "AR",
            "postal_code": "71961",
            "country_code": "US",
            "telephone_number": "479-216-4262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "117 Ray Dr.",
            "address_purpose": "LOCATION",
            "city": "Mt. Ida",
            "state": "AR",
            "postal_code": "71957",
            "country_code": "US",
            "telephone_number": "479-437-7967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRACY KENNEDY COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-216-4262"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tracy Kennedy Counseling LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kara Danielle Tedford, CNP
• Trista Tetro
• The Guidance Center - Mena Clinic
• The Guidance Center - Polk County Sats
• Brandi Titsworth, LPC
• Chau Tran, PHARMD
• Rhonda Tranter, RN
• Barbara Travis, APRN
• TTJ, Inc
• Farrah Nicole Tucker Jordan

• Professional Counselor in Mena, AR
• Providers in Mena, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.