MEDICARE: TRACY CATHLEEN DOERING ED.S., LMHC, NCC

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	101YM0800X	Mental Health Counselor	MH 8553	FL

General Provider Information

NPI Number	:	1235114356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY CATHLEEN DOERING ED.S., LMHC, NCC

Provider Business Mailing Address
First Line	:	5745 SW 75TH ST # 252
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-5504
Country	:	US
Telephone Number	:	352-219-6109
Fax Number	:

Provider Business Practice Location Address
First Line	:	4809 SW 91ST TER
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-6033
Country	:	US
Telephone Number	:	352-373-0030
Fax Number	:

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

Provider Enumeration Date	:	12/12/2005
Last Update Date	:	05/10/2018

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