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NPI Code Detail

MEDICARE: MRS. TRACY JONES KINSLEY LPC, CAC III

MEDICARE: MRS. TRACY JONES KINSLEY LPC, CAC III
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLPC-3151CO
2101YA0400XAddiction (Substance Use Disorder) CounselorACC-6167CO
3101YA0400XAddiction (Substance Use Disorder) Counselor6167CO
4101YP2500XProfessional Counselor3151CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003959651
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TRACY JONES KINSLEY LPC, CAC III
Provider Business Mailing Address
First Line : 2021 W COLORADO AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-3840
Country : US
Telephone Number : 719-659-0512
Fax Number : 719-520-3974
Provider Business Practice Location Address
First Line : 2021 W COLORADO AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-3840
Country : US
Telephone Number : 719-659-0512
Fax Number : 719-520-3974
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2007
Last Update Date : 12/12/2011

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