MEDICARE: TRACY TREACY M.S,, LPC, CADC-1

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
1	101Y00000X	Counselor	2555-125	WI
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	2555125	WI
3	101YM0800X	Mental Health Counselor	2555-125	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2161	OTHER	WI	PROVIDER # WISER CHOICE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114066552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY TREACY M.S,, LPC, CADC-1

Provider Business Mailing Address
First Line	:	2568 N DR MARTIN LUTHER KING DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53212-2710
Country	:	US
Telephone Number	:	414-265-0300
Fax Number	:	414-265-0200

Provider Business Practice Location Address
First Line	:	2568 N DR MARTIN LUTHER KING DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53212-2710
Country	:	US
Telephone Number	:	414-265-0300
Fax Number	:	414-265-0200

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	09/11/2025

Similar Medicare Providers

1790010718 — D & S HEALING CENTER
Practice Location Address:

2568 N MARTIN LUTHER KING DR
MILWAUKEE, WI
53212-2710

Practice Phone: 414-265-0300
Practice Fax: 414-265-0200

1124459664 — CHARLES HALL C.O.
Practice Location Address:

2578 N MARTIN LUTHER KING DR
MILWAUKEE, WI
53212-2710

Practice Phone: 414-374-4256
Practice Fax:

1336561844 — HALL'S BRACE CENT
Practice Location Address:

2578 N MARTIN LUTHER KING DR
MILWAUKEE, WI
53212-2710

Practice Phone: 414-581-4255
Practice Fax:

1962994780 — NANCY GRIMM PTA
Practice Location Address:

2578 N MARTIN LUTHER KING DR
MILWAUKEE, WI
53212-2710

Practice Phone: 414-562-4386
Practice Fax: 414-562-4397

1922769983 — ADVANTAGE PT & SPORTS REHAB LLC
Practice Location Address:

2578 N MARTIN LUTHER KING DR
MILWAUKEE, WI
53212-2710

Practice Phone: 414-529-7375
Practice Fax:

1679362461 — ELIZABETH NGUTSE
Practice Location Address:

2578 N DR MARTIN LUTHER KING JR DR
MILWAUKEE, WI
53212-2710

Practice Phone: 414-562-4386
Practice Fax:

Directions to “ TRACY TREACY M.S,, LPC, CADC-1” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.