MEDICARE: MRS. TRACY LYNN SMITH BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-06-2908	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558600049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TRACY LYNN SMITH BCBA

Provider Business Mailing Address
First Line	:	1110 13TH ST STE D
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31901-2246
Country	:	US
Telephone Number	:	706-780-1704
Fax Number	:	706-780-1705

Provider Business Practice Location Address
First Line	:	1110 13TH ST STE D
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31901-2246
Country	:	US
Telephone Number	:	888-963-2228
Fax Number	:	706-780-1705

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2013
Last Update Date	:	08/14/2025

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