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General NPI Number Information
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NPI Number | 1295756229
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Entity Type | Individual
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Provider Name | TRACEY LEIGH FLENIKEN LPC
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Gender | Female
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 115 N COMMERCE ST
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City | GAINESVILLE
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State | TX
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Zip | 76240-3911
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Country | US
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Telephone | 940-665-8056
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Fax | 940-665-8057
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Provider Business Mailing Address
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Address Line | PO BOX 173
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City | SAINT JO
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State | TX
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Zip | 76265-0173
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Country | US
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Telephone | 469-387-9528
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 18411
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License Number State | TX
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