LAURA KORENSTRA TRACEY (NPI# 1023273596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023273596 |
| Entity Type | Individual |
| Full Name | LAURA KORENSTRA TRACEY |
| Practice Address |
125 N Lake St Manistique MI 49854-1234 |
| Practice Telephone | 9063415214 |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2008-07-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers |
| Street Address |
125 N LAKE ST |
| City | MANISTIQUE |
| State | MI |
| Zip Code | 49854-1234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740378827 | Dan Mckinny | Counselor | 125 N Lake St, Manistique, MI 49854-1234 | 2006-10-11 |
| 1245860717 | Breanna Trail | Social Worker | 125 N Lake St, Manistique, MI 49854-1234 | 2020-01-23 |
| 1285139642 | Kellie Campbell | Social Worker | 125 N Lake St, Manistique, MI 49854-1234 | 2018-03-28 |
| 1780185371 | Alyssa Strasser | Social Worker | 125 N Lake St, Manistique, MI 49854-1234 | 2018-02-28 |
| 1760816789 | Connie Hadel | Social Worker | 125 N Lake St, Manistique, MI 49854-1234 | 2013-08-27 |
| 1922432038 | Sanja Teresa Roberts | Registered Nurse | 125 N Lake St, Manistique, MI 49854-1234 | 2013-08-26 |
| 1871894584 | Kristine Jensen | Registered Nurse | 125 N Lake St, Manistique, MI 49854-1234 | 2010-11-11 |
| 1972835262 | Linda Norlander | Social Worker | 125 N Lake St, Manistique, MI 49854-1234 | 2010-02-11 |
| 1386971422 | Jesselyn Bourque | Social Worker | 125 N Lake St, Manistique, MI 49854-1234 | 2009-11-11 |
| 1508192238 | Heide Erickson | Social Worker | 125 N Lake St, Manistique, MI 49854-1234 | 2009-10-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134752215 | Sarah Jo Miller | Massage Therapist | 610 E Lakeshore Dr, Manistique, MI 49854 | 2020-02-18 |
| 1669961611 | Carole Lynn Hare | Counselor | 159 N Maple Stree, Manistique, MI 49854 | 2018-05-05 |
| 1457898165 | Mark A Rohde | Pharmacist | 211 S Cedar Street, Manistique, MI 49854 | 2017-01-20 |
| 1801137229 | Tracey A Marino | Nurse Practitioner | 7870 W. Us 2, Schoolcraft Memorial Hospital, Manistique, MI 49854 | 2013-03-11 |
| 1366786303 | Melissa L Carlson | Counselor | 5698 W. Hwy Us2, Manistique, MI 49854 | 2012-11-15 |
| 1255666939 | Little Ones of The Up, LLC | Community/Behavioral Health | 300 Walnut Rm 155, Manistique, MI 49854 | 2009-10-13 |
| 1629303441 | Great Lakes Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 601 Lakeshore Drive, Suite 101, Manistique, MI 49854 | 2009-10-13 |
| 1073756961 | Trisha Ann Mcevers | Social Worker | 601 E. Lakeshore Drive, Suite 102, Manistique, MI 49854 | 2009-04-08 |
| 1043359409 | Nora Lynn Brewster | Social Worker | 8716 N Boot Lake Rd, Manistique, MI 49854 | 2007-02-05 |
| 1588717839 | Sault Tribe of Chippewa Indians | Clinic/Center | 5698w Hwy Us2, Manistique, MI 49854 | 2007-01-19 |
| Find all providers in zip 49854 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820598 | Alexander William Krieg | Psychologist | 31235 Ramble Rd, Franklin, MI 48025-1367 | 2020-10-26 |
| 1699389395 | Linda D Seltzer-sucher Phd LLC | Psychologist | 275 Bryn Mawr St, Birmingham, MI 48009-1501 | 2020-09-01 |
| 1780154435 | Erica Griffis Prime | Psychologist | 28066 Sunset Blvd W, Lathrup Village, MI 48076-2658 | 2018-11-26 |
| 1932600772 | Grand Blanc Psychology Pllc | Psychologist | 8382 Holly Rd Ste 1, Grand Blanc, MI 48439-1972 | 2018-02-27 |
| 1649792292 | Livingston Psychological Services, Pllc | Psychologist | 204 W Grand River Ave Ste 260, Howell, MI 48843 | 2017-07-14 |
| 1720529779 | Dannison | Psychologist | 604 S Rose St, Kalamazoo, MI 49007 | 2017-03-10 |
| 1912356254 | Maurice Moses Jr. | Psychologist | 541 Walbridge Dr, East Lansing, MI 48823-2039 | 2016-06-07 |
| 1538531017 | Life Journey Pllc | Psychologist | 2013 East Castle Drive Sw, Suite B, Grand Rapids, MI 49508 | 2015-10-23 |
| 1548654148 | Darya Owens | Psychologist | 1235 Saint Clair St, Detroit, MI 48214-3671 | 2015-03-23 |
| 1538582671 | Laura Ann Wyglinski, Ph. D. | Psychologist | 4675 Okemos Rd, Okemos, MI 48864-1974 | 2014-01-25 |
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| City | MANISTIQUE |
| Zip Code | 49854 |
Please comment or provide details below to improve the information on LAURA KORENSTRA TRACEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.