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NPI Code Detail

MEDICARE: TRACIE L TIMME MS, LCPC

MEDICARE: TRACIE L TIMME MS, LCPC
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 CounselorCP5379NV

General Provider Information

NPI Number : 1467096156
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACIE L TIMME MS, LCPC
Provider Business Mailing Address
First Line : 8945 W RUSSELL RD STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1225
Country : US
Telephone Number : 702-476-9294
Fax Number :
Provider Business Practice Location Address
First Line : 8945 W RUSSELL RD STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1225
Country : US
Telephone Number : 702-476-9294
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2019
Last Update Date : 04/01/2024

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Directions to “ TRACIE L TIMME MS, LCPC” Practice Location

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