Tracey Johnson, | |
2947 Mere Ln, Grand Prairie, TX 75054-0190 | |
(214) 280-3053 | |
Not Available |
Full Name | Tracey Johnson |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 2947 Mere Ln, Grand Prairie, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013799956 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 88837 (Texas) | Secondary |
101YP2500X | Counselor - Professional | 88837 (Texas) | Primary |
Entity Name | Sondermind Provider Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210326001541 |
Mailing Address | Practice Location Address |
---|---|
Tracey Johnson, 2947 Mere Ln, Grand Prairie, TX 75054-0190 Ph: (214) 280-3053 | Tracey Johnson, 2947 Mere Ln, Grand Prairie, TX 75054-0190 Ph: (214) 280-3053 |
Ada M Hall, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2778 Sun Rise Ln, Grand Prairie, TX 75052 Phone: 214-202-4567 | |
Mr. Patrick Robert Gibson, LPC, LMFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 1020 S Carrier Pkwy, Grand Prairie, TX 75051 Phone: 214-743-1200 Fax: 817-451-1331 | |
Hui-li Walker, M.A., LPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4110 Scotland Dr, Grand Prairie, TX 75052 Phone: 682-331-2239 | |
David Terpstra, MED LPC LMFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 530 S Carrier Parkway, Ste 397, Grand Prairie, TX 75051 Phone: 214-354-3648 Fax: 214-824-0414 | |
Jacqueline Jernigan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4683 Betts Dr Ste 403, Grand Prairie, TX 75052 Phone: 469-726-9813 | |
Darla R. Booker, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2615 Lake Point Dr Apt 816, Grand Prairie, TX 75050 Phone: 405-255-8122 |