NPI Code Detail JSON Logo

1700581121 NPI number — TRACEY DELONCE TAYLOR BCJ/DPCADC

NPI Number: 1700581121
Health Care Provider/Practitioner: TRACEY DELONCE TAYLOR BCJ/DPCADC

Information about “1700581121” NPI (TRACEY DELONCE TAYLOR BCJ/DPCADC) exists in 1700581121 in HTML format HTML  |  1700581121 in plain Text format TXT  |  1700581121 in PDF (Portable Document Format) PDF  |  1700581121 in an XML format XML  formats.

NPI Number : 1700581121 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700581121",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TAYLOR",
    "FirstName": "TRACEY",
    "MiddleName": "DELONCE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "BCJ/DPCADC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "17160 GRAVIER ST APT 4B",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DETROIT",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48224-2265",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "313-883-5614",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "626 E GRAND BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DETROIT",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48207-3513",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "313-883-5614",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/04/2023",
    "LastUpdateDate": "04/04/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YA0400X",
        "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.