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NPI 1053538108

NPI 1053538108 : TRACY ANN THOMPSON LMFT, CADCII : SANTA BARBARA, CA

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General NPI Number Information
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    NPI Number           |    1053538108
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    Entity Type          |    Individual 
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    Provider Name        |    TRACY ANN THOMPSON LMFT, CADCII
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/19/2007
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    Last Update Date     |    04/19/2021
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Provider Practice Location Address
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    Address Line         |    123 W GUTIERREZ ST 
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    City                 |    SANTA BARBARA
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    State                |    CA
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    Zip                  |    93101-3424
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    Country              |    US
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    Telephone            |    323-821-6855
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    123 W GUTIERREZ ST 
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    City                 |    SANTA BARBARA
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    State                |    CA
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    Zip                  |    93101-3424
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    Country              |    US
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    Telephone            |    323-821-6855
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    I2490607
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    125306
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    License Number State |    CA
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