TRACY MARSHALL (NPI# 1942665567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942665567 |
| Entity Type | Individual |
| Full Name | TRACY MARSHALL |
| Practice Address |
255 Grimes Rd Woodstock GA 30188-6725 |
| Practice Telephone | 6783666050 |
| Practice Fax Number | 6783666051 |
| Mailing Telephone | 6783666050 |
| Mailing Fax Number | 6783666051 |
| Enumeration Date | 2015-12-25 |
| Last Update Date | 2015-12-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 320900000X | GA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619414067 | Tracy Marshall | Licensed Practical Nurse | 6081 Brofield Dr, Hamilton, OH 45011-5154 | 2017-01-24 |
| 1245627553 | Tracy Marshall | Licensed Practical Nurse | 112 N. Reservation Rd, Mcdermitt, NV 89421 | 2015-04-24 |
| 1538313101 | Tracy Jones Marshall | Licensed Practical Nurse | 940 Highway 96 Ste A, Warner Robins, GA 31088-2587 | 2008-11-10 |
| 1285898700 | Tracy Lee Marshall | Counselor | 2153 E Joyce Blvd, Fayetteville, AR 72703-4714 | 2008-07-14 |
| 1114463965 | Tracy Marshall | Social Worker | 930 W Harris St, Eureka, CA 95503-3927 | 2017-01-17 |
| 1316206089 | Tracy A Marshall | Case Manager/Care Coordinator | 4 S Main St, Fall River, MA 02721-5327 | 2012-05-15 |
| 1114117884 | Tracy Marshall | Counselor | 28545 Highway 18, Skyforest, CA 92385-0578 | 2007-07-30 |
| 1386852531 | Tracy Marshall | Physical Therapy Assistant | 1941 Savage Rd, Suite 400c, Charleston, SC 29407-4704 | 2007-05-20 |
| 1497863625 | Tracy Marshall | Speech-Language Pathologist | 5645 Main St, Flushing, NY 11355-5045 | 2006-08-28 |
| Street Address |
255 GRIMES RD |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30188-6725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548627482 | Blessing Deeyaa | Counselor | 255 Grimes Rd, Woodstock, GA 30188-6725 | 2016-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730715814 | Tyler Rose | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 South Mill Creek Court, Woodstock, GA 30188 | 2020-03-20 |
| 1881224897 | Dr. Tom LLC | Clinic/Center | 5431 Old Highway 5 Ste 206, Holly Springs, GA 30188 | 2020-01-17 |
| 1467090175 | Stacey Robin Hill | Dietitian, Registered | 210 Mcaffee St, Street Address 2, Woodstock, GA 30188 | 2019-12-12 |
| 1326681784 | Margo Vanderveen | Massage Therapist | 605 Old Hickory Road, Woodstock, GA 30188 | 2019-10-17 |
| 1275093437 | Rebekah Ruth Tchouta | Social Worker | 5166 Shotwell St, Woodstock, GA 30188 | 2019-03-23 |
| 1205395829 | Angela M Graves | Behavior Technician | 3229 S Cherokee Ln Ste 1400, Woodstock, GA 30188 | 2019-03-13 |
| 1396233391 | Costco Wholesale Corporation | Hearing Aid Equipment | 113 Lincoln Street, Woodstock, GA 30188 | 2018-04-25 |
| 1659878080 | Alexis K. Brown | Counselor | 3380 Trickum Rd., Bldg 700, Woodstock, GA 30188 | 2018-04-11 |
| 1427555440 | Lisa Marie Anthony | Specialist/Technologist | 400 Arnold Mill Rd, Woodstock, GA 30188 | 2018-04-06 |
| 1497254122 | J.a.h. Enterprises, LLC | Audiologist | 12195 Hwy. 92, Suite 114-325, Woodstock, GA 30188 | 2018-02-08 |
| Find all providers in zip 30188 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689002958 | Life Well Lived Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6941 Highway 92, Suite 120, Woodstock, GA 30189-3465 | 2013-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790385862 | Hickory Log Vocational School Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3680 Highway 411 Ne, White, GA 30184-2427 | 2020-10-28 |
| 1801403050 | Safe Haven Personal Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10875 Abercorn St Apt 132, Savannah, GA 31419-1843 | 2020-09-30 |
| 1659987931 | Pinkies Place | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 216 Self St, Warner Robins, GA 31088-5506 | 2020-09-22 |
| 1629680293 | Caregiver Ga, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3736 Executive Center Dr Ste B, Augusta, GA 30907-2360 | 2020-08-17 |
| 1730799073 | Victory Won Counseling and Res Care Prof. Corp | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5014 Snapfinger Woods Dr, Decatur, GA 30035-4003 | 2020-08-02 |
| 1811528649 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 211 North Street, Douglas, GA 31533 | 2020-01-30 |
| 1619519709 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 516 Freedom Trl, Brunswick, GA 31525-4712 | 2019-10-10 |
| 1215581756 | Elegant Lm Management, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1020 Meadowsong Circle, Lawrenceville, GA 30043 | 2019-08-01 |
| 1467013821 | Csb of East Central Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5101 Parnell Way, Martinez, GA 30907-8896 | 2019-06-26 |
| 1013474915 | Community Service Board of East Central Georgia | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1715 Lawerence Rd, Hephzibah, GA 30815-4445 | 2019-02-27 |
| Find all providers with the same taxonomy | ||||
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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.