Provider Demographics
NPI:1538058235
Name:PARSON, TRACIE
Entity type:Individual
Prefix:
First Name:TRACIE
Middle Name:
Last Name:PARSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 E MONUMENT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1151
Mailing Address - Country:US
Mailing Address - Phone:254-730-0453
Mailing Address - Fax:
Practice Address - Street 1:2993 BROADMOOR VALLEY RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4471
Practice Address - Country:US
Practice Address - Phone:719-301-7731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling