Tracey R. Fintel, PHD, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LC1185766 Issued in MO

Legal business name

TRACEY R. FINTEL, PHD, LLC

Practice address

9890 Clayton Rd
Suite 133
Saint Louis, MO 63124-1685

Phone

(314) 725-1515

Fax

(314) 222-6321

NPI assigned

Dec 20, 2011

Organization subpart

No

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

Authorized official

Name

Tracey R Fintel, PHD

Title

Sole Member

Phone

(314) 725-1515

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1982973053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9890 CLAYTON RD",
            "address_2": "SUITE 133",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241685",
            "telephone_number": "314-725-1515",
            "fax_number": "314-222-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9890 CLAYTON RD",
            "address_2": "SUITE 133",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241685",
            "telephone_number": "314-725-1515",
            "fax_number": "314-222-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACEY R. FINTEL, PHD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "FINTEL",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "314-725-1515",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "LC1185766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.