Provider Demographics
NPI:1154139699
Name:FEGGINS-SINGLETON, TRACEY
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:FEGGINS-SINGLETON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 225
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:VA
Mailing Address - Zip Code:23950-0225
Mailing Address - Country:US
Mailing Address - Phone:434-253-3088
Mailing Address - Fax:434-253-3082
Practice Address - Street 1:100 N CARTER ST
Practice Address - Street 2:SUITE 7B
Practice Address - City:LACROSSE
Practice Address - State:VA
Practice Address - Zip Code:23950
Practice Address - Country:US
Practice Address - Phone:434-253-3088
Practice Address - Fax:434-253-3082
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101YA0400X, 101Y00000X, 101YP2500X, 171M00000X
101YM0800X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty