Active NPI
Tracy Lynn Wilson, LPCC, LSW, LICDC
- Mental Health Counselor
- Springboro, OH
National Provider Identifier
1891945788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- E0002898
- Practice address
- 84 Remick Blvd
Springboro, OH 45066-9168 - Phone
- (937) 619-0444
- Fax
- (937) 619-0445
- NPI assigned
- Sep 26, 2008
- Last updated
- Sep 26, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 965776 | OH | |
| Mental Health Counselor | 101YM0800X | E0002898 | OH | Primary |
| Clinical Social Worker | 1041C0700X | S0013519 | OH |
Addresses
Primary practice location
84 Remick Blvd
Springboro, OH 45066-9168
Mailing address
84 Remick Blvd
Springboro, OH 45066-9168
Phone (937) 619-0444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 965776 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| E0002898 | OH | MD | Mental Health Counselor |
| S0013519 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222387200000",
"number": "1891945788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "84 REMICK BLVD",
"city": "SPRINGBORO",
"state": "OH",
"postal_code": "450669168",
"telephone_number": "937-619-0444",
"fax_number": "937-619-0445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 REMICK BLVD",
"city": "SPRINGBORO",
"state": "OH",
"postal_code": "450669168",
"telephone_number": "937-619-0444",
"fax_number": "937-619-0445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "TRACY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "LPCC, LSW, LICDC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-26",
"last_updated": "2008-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "965776",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E0002898",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "S0013519",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springboro, OH
- Brittani Williamson, APRN, FNP
- Charise Wilson-Hammond, OCCUPATIONAL THERAPI
- Kathryn A.S. Wilson, DO, LLC
- Kristofer Michael Wilson, DPT
- Shawnta Jolan Wilson, RN
- Hannah Elizabeth Winkler, ARNP
- Hannah S Wireman, RA
- Sheila Ann Wolsefer, C.D.A.
- Worthington Chiropractic, Inc.
- Wound Healing Specialists of Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.