Individual provider Active NPI

Ryan David Tracy, LCPC

  • Professional Counselor
  • Severna Park, MD
National Provider Identifier
1972158574
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC7319 Issued in MD
Practice address
819 Ritchie Hwy
Severna Park, MD 21146-4197
Phone
(410) 431-5111
Fax
(410) 431-5112
NPI assigned
Aug 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC7319 MD Primary

Addresses

Primary practice location

819 Ritchie Hwy
Severna Park, MD 21146-4197

Mailing address

819 Ritchie Hwy Ste 1020
Severna Park, MD 21146-4193
Phone (410) 431-5111

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

LicenseStateTypeSpecialty
LC7319MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Remedy Counseling, LLC CurrentSince Aug 11, 2019 Accepting new patients

Locations

819 Ritchie Hwy
Ste 1020
Severna Park, MD 21146
Phone (410) 431-5111

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1972158574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 RITCHIE HWY STE 1020",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211464193",
            "telephone_number": "410-431-5111",
            "fax_number": "410-431-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 RITCHIE HWY",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211464197",
            "telephone_number": "410-431-5111",
            "fax_number": "410-431-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "RYAN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC7319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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.