MEDICARE: TRACI W. REISER MFTC

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	101YM0800X	Mental Health Counselor	MFTC.0014932	CO

General Provider Information

NPI Number	:	1588515258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACI W. REISER MFTC

Provider Business Mailing Address
First Line	:	PO BOX 874
Second Line	:
City	:	CRESTED BUTTE
State	:	CO
Zip	:	81224-0874
Country	:	US
Telephone Number	:	512-247-8453
Fax Number	:

Provider Business Practice Location Address
First Line	:	48 CINNAMON MOUNTAIN RD
Second Line	:
City	:	CRESTED BUTTE
State	:	CO
Zip	:	81225-5401
Country	:	US
Telephone Number	:	512-247-8453
Fax Number	:

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

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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