Provider Demographics
NPI:1639833593
Name:JONES, TRACY (MS; ALC)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MS; ALC
Other - Prefix:MS
Other - First Name:TRACY
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1367 COUNTY ROAD 1166
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36079-4407
Mailing Address - Country:US
Mailing Address - Phone:334-372-8649
Mailing Address - Fax:
Practice Address - Street 1:1367 COUNTY ROAD 1166
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36079-4407
Practice Address - Country:US
Practice Address - Phone:334-372-8649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL101Y00000X, 101YA0400X, 101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health