MEDICARE: TRACEY ARLEICIA PICOU

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		VA

General Provider Information

NPI Number	:	1891638078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACEY ARLEICIA PICOU

Provider Business Mailing Address
First Line	:	4401 TELFAIR BLVD APT 3326
Second Line	:
City	:	SUITLAND
State	:	MD
Zip	:	20746-5285
Country	:	US
Telephone Number	:	910-751-2053
Fax Number	:

Provider Business Practice Location Address
First Line	:	5901 KINGSTOWNE VILLAGE PKWY
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22315-5880
Country	:	US
Telephone Number	:	910-751-2053
Fax Number	:

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

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “ TRACEY ARLEICIA PICOU ” Practice Location

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