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General NPI Number Information
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NPI Number | 1073723193
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Entity Type | Individual
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Provider Name | TRACY LEVON TOWNSEND LPC, LPCC
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Gender | Female
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 05/14/2010
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Provider Practice Location Address
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Address Line | 2041 S PACHECO ST STE 100
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City | SANTA FE
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State | NM
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Zip | 87505-6478
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Country | US
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Telephone | 512-633-7505
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10182
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City | SANTA FE
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State | NM
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Zip | 87504-6182
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Country | US
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Telephone | 505-984-1555
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 17526
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0131391
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License Number State | NM
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