Tracey Sue Pearson-Heaney, M.A., L.P.C, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2014021704 Issued in MO

Practice address

2148 Vadalabene Dr
Maryville, IL 62062-5632

Phone

(618) 288-3100

Fax

(618) 288-3371

NPI assigned

Mar 28, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1952677510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 N KIRKWOOD RD STE 102",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631224042",
            "telephone_number": "618-444-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2148 VADALABENE DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625632",
            "telephone_number": "618-288-3100",
            "fax_number": "618-288-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON-HEANEY",
        "first_name": "TRACEY",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "M.A., L.P.C, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2014021704",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180009843",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490055312",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Maryville, IL
• Providers in Maryville, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.