DR. MICHAEL LAWRENCE TRACY (NPI# 1063719631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063719631 |
Entity Type | Individual |
Full Name | DR. MICHAEL LAWRENCE TRACY |
Credential | PH.D. |
Practice Address |
201 N Rose Ave Indiana University School of Education 4046 Bloomington IN 47405-1005 |
Practice Telephone | 8128568345 |
Practice Fax Number | 8128568333 |
Mailing Telephone | 8128568345 |
Mailing Fax Number | 8128568333 |
Enumeration Date | 2011-02-17 |
Last Update Date | 2011-02-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
20090109A | IN | Behavioral Health & Social Service Providers |
N | 106H00000X | Marriage & Family Therapist | 35001023A | IN | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033312285 | Michael W Tracy | Social Worker | 411 N Brigham Ave, American Fork, UT 84003-1835 | 2007-06-06 |
1124229380 | Michael Kennedy Tracy | Ophthalmology | 6183 Paseo Del Norte Ste 290, Carlsbad, CA 92011-1151 | 2007-05-29 |
1295995751 | Michael C Tracy | Pediatrics | 725 Welch Rd, Palo Alto, CA 94304-1601 | 2008-06-09 |
1477733061 | Michael Richard Tracy | Orthopaedic Surgery | 334 Main St, Dickson City, PA 18519-1668 | 2007-11-12 |
1770778805 | Michael B Tracy | Physical Medicine & Rehabilitation | 380 Empire Rd, Suite 200, Lafayette, CO 80026-2677 | 2007-09-11 |
1780749135 | Michael Spencer Tracy | Nurse Anesthetist, Certified Registered | 975 Sereno Dr, Vallejo, CA 94589-2485 | 2006-12-26 |
1124054945 | Michael C Tracy | Emergency Medicine | 1800 Barrs St, Jacksonville, FL 32204-4704 | 2006-06-23 |
1689662595 | Michael D Tracy | Internal Medicine | 450 Mountain View St, Powell, WY 82435-2212 | 2005-10-13 |
Street Address |
201 N ROSE AVE INDIANA UNIVERSITY SCHOOL OF EDUCATION 4046 |
City | BLOOMINGTON |
State | IN |
Zip Code | 47405-1005 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245352855 | Kimberly Wagner | Psychologist | 201 N Rose Ave, Room 32, Bloomington, IN 47405-1005 | 2007-04-04 |
1467771337 | Lynn Gilman | Psychologist | 201 N Rose Ave, Suite 0001, Bloomington, IN 47405-1005 | 2010-05-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245786896 | Jennifer Whitley | Speech-Language Pathologist | 200 S. Jordan Avenue, Bloomington, IN 47405 | 2016-09-01 |
1801342621 | William Daniels Jr. | Health Educator | 600 N. Jordan Ave., Bloomington, IN 47405 | 2016-08-31 |
1588053664 | Sara Anne Boyer | Preventive Medicine | 1025 E. 7th Street, Rm C200, School of Public Health, Indiana University, Bloomington, IN 47405 | 2015-01-13 |
1437438181 | Walter Lawrence Campbell | Counselor | 600 N. Jordan Ave, Bloomington, IN 47405 | 2011-08-12 |
1568580314 | Linda Jean Noble | Physical Therapist | Indiana University Health Center, 600 North Jordan Ave., Bloomington, IN 47405 | 2007-03-27 |
1811482854 | Alexandria Lui | Optometrist | 744 E 3rd St, Bloomington, IN 47405 | 2018-06-22 |
1295234763 | Joshua Allan Stommes | Optometrist | 800 E Atwater Ave, Bloomington, IN 47405 | 2018-02-09 |
1548410038 | Elin C Grimes | Dietitian, Registered | 600 N Jordan Ave, Indiana University Health Center, Bloomington, IN 47405 | 2008-09-22 |
1366432528 | Rebecca D. Eberle | Speech-Language Pathologist | 200 S Jordan Ave, Department of Speech and Hearing Sciences, Bloomington, IN 47405 | 2005-10-27 |
1477171122 | Ellen Vaughan | Psychologist | 201 N Rose Ave Rm 4054, Bloomington, IN 47405-1005 | 2020-07-09 |
Find all providers in zip 47405 |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154885028 | Sara J. W. Biebl, Ph.d., Licensed Psychologist, Pllc | Psychologist | 7900 Xerxes Ave S Ste 1125, Bloomington, MN 55431-1112 | 2019-01-24 |
1053894501 | Thrive Psychology Services, LLC | Psychologist | 4120 W Dresden Dr, Bloomington, IN 47404-8403 | 2018-09-11 |
1194184465 | Chjl LLC | Psychologist | 8120 Penn Ave S Ste 252, Bloomington, MN 55431-1358 | 2016-02-16 |
1992100077 | Lindeman and Associates, LLC | Psychologist | 3802 E 3rd St, Suite 220, Bloomington, IN 47401-5504 | 2014-10-30 |
1255772174 | Amanda Quinby | Psychologist | 205 N College Ave Ste 512, Bloomington, IN 47404-3952 | 2013-07-08 |
1457609802 | Jason Vasquez | Psychologist | 2416 Washington, A-3, Bloomington, IL 61704 | 2012-08-16 |
1710282058 | Annorah Sheeran Moorman | Psychologist | 1319 Fell Ave, Bloomington, IL 61701-1828 | 2011-01-18 |
1477860609 | Hoffmann Burchett Psychological Services, LLC | Psychologist | 205 N Williamsburg Dr, Suite F, Bloomington, IL 61704-7706 | 2010-09-09 |
1356654693 | James Wiltz | Psychologist | 2745 E Elderberry Ct, Bloomington, IN 47401-4307 | 2010-07-15 |
1528207784 | Jennifer Elizabeth Koch | Psychologist | 2502 E Empire St Ste C, Bloomington, IL 61704-3739 | 2009-02-11 |
Find all providers in BLOOMINGTON |
City | BLOOMINGTON |
Zip Code | 47405 |
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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.