Provider Demographics
NPI:1669515193
Name:TIPTON, TRACY LYNN (LPC)
Entity type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:LYNN
Last Name:TIPTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:TRACY
Other - Middle Name:LYNN
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 CHINABERRY WAY
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2960
Mailing Address - Country:US
Mailing Address - Phone:918-640-2529
Mailing Address - Fax:
Practice Address - Street 1:210 CHINABERRY WAY
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-2960
Practice Address - Country:US
Practice Address - Phone:918-640-2529
Practice Address - Fax:918-640-2529
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4166101Y00000X
TX91807101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor