Provider Demographics
NPI:1316067945
Name:SALMON, TRACIE MORRISON (LPC, LMFT, LCDC)
Entity type:Individual
Prefix:MRS
First Name:TRACIE
Middle Name:MORRISON
Last Name:SALMON
Suffix:
Gender:F
Credentials:LPC, LMFT, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5934 ROYAL LN
Mailing Address - Street 2:STE 209
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-3870
Mailing Address - Country:US
Mailing Address - Phone:214-750-1991
Mailing Address - Fax:214-750-1986
Practice Address - Street 1:5934 ROYAL LN
Practice Address - Street 2:STE 209
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-3870
Practice Address - Country:US
Practice Address - Phone:214-750-1991
Practice Address - Fax:214-750-1986
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5426101YA0400X
TX10066101YM0800X
TX2904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00002338LCOtherBCBSTX NUMBER