DR. TRACEY THIBODEAU LPC, LAC, EDD
NPI 1356161715
Counselor - Professional in Overland Park, KS
Active since October 11, 2024
About Dr. Tracey Thibodeau Lpc, Lac, Edd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. TRACEY THIBODEAU LPC, LAC, EDD (NPI 1356161715) is an individual professional provider in Overland Park, Kansas, licensed in Kansas (04842) and active in the NPI registry since October 2024. She maintains a secondary practice location in Leawood.
NPPES Registry Identity
NPI1356161715
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameDR. TRACEY THIBODEAUCredential: LPC, LAC, EDD
Location Address9302 W 121ST TEROverland Park, KS 66213-1547
Mailing Address9302 W 121st TerOverland Park, KS 66213-1547 · (951) 255-8242
Phone(951) 255-8242
Sole ProprietorYes
Enumeration DateOctober 11, 2024
NPPES CertifiedOctober 11, 2024
✔ NPI 1356161715 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in KS · 04842
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 01942 (KS)
9302 W 121ST TER, Overland Park, KS 66213
Secondary Practice Location 1
Location 14701 College Blvd Ste 115Leawood, KS 66211-1608 · Phone (913) 777-4020
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1356161715, enumerated as an "individual" on October 11, 2024.
The provider is located at 9302 W 121ST TER OVERLAND PARK, KS 66213 and the phone number is (951) 255-8242.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
