Provider Demographics
NPI:1194068809
Name:HUNTER, TRACY LYNN (LPC)
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:LYNN
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 PENDALL DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-5563
Mailing Address - Country:US
Mailing Address - Phone:972-215-9535
Mailing Address - Fax:
Practice Address - Street 1:505 WOODBRIDGE PKWY STE 300
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-7127
Practice Address - Country:US
Practice Address - Phone:972-989-7655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-01
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67472101YP2500X
TX101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)