TRACY DOERR LPCC/LADC NPI 1194492025

NPI Information

NPI: 1194492025
Provider Name: TRACY DOERR, LPCC/LADC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
10464 HOLLYWOOD BLVD NW
COON RAPIDS, MN
ZIP 55433
Phone: (612) 900-8934
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Tracy Doerr, LPCC/LADC is a mental health counselor in Coon Rapids, MN. Tracy Doerr, LPCC/LADC NPI is 1194492025. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10464 HOLLYWOOD BLVD NW
COON RAPIDS, MN
ZIP 55433-517
Phone: (612) 900-8934

The enumeration date for this NPI number is 8/27/2021 and was last updated on 2/20/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	303832	MINNESOTA	No
2	101YP2500X	Counselor	Professional	3801	MINNESOTA	No
3	101YM0800X	Counselor	Mental Health	3801	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	N204188757206	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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