Healthcare Provider Details

I. General information

NPI: 1083245773
Provider Name (Legal Business Name): TRACI HUYNH LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2020
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11400 AIRPORT RD
EVERETT WA
98204
US

IV. Provider business mailing address

352 OAK GROVE ISLAND DRIVE
BRUNSWICK GA
31523
US

V. Phone/Fax

Practice location:
  • Phone: 877-622-0013
  • Fax:
Mailing address:
  • Phone: 404-913-7774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7952
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC010966
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61633940
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: