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TRACIE LYN HANSEN B.S.
NPI 1639779523
Peer Specialist in Pocatello, ID

Active since October 29, 2020
560 FAIRWAY DR, POCATELLO, ID 83201(208) 242-6669 Get Directions Write a Review

NPPES record last updated: October 14, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 10, 2023, Oct 29, 2020 (2 updates tracked since 2020).

About Tracie Lyn Hansen B.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRACIE LYN HANSEN B.S. (NPI 1639779523) is an individual peer specialist in Pocatello, Idaho, licensed in Idaho (CPSS055) and active in the NPI registry since October 2020.

NPPES Registry Identity

NPI1639779523
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameTRACIE LYN HANSENCredential: B.S.
Location Address560 FAIRWAY DRPocatello, ID 83201-2012
Mailing Address611 Wilson Ave Ste 5Pocatello, ID 83201-5046 · (208) 915-8448
Phone(208) 242-6669
Sole ProprietorYes
Enumeration DateOctober 29, 2020
Last NPPES UpdateOctober 14, 20252 updates tracked since enumeration
NPPES CertifiedOctober 14, 2025
✔ NPI 1639779523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in ID · CPSS055
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
560 FAIRWAY DR, Pocatello, ID 83201
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Other Names 1

Former Name (1)Tracie Lyn Burrup

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tracie Hansen's NPI number?

The NPI number for Tracie Hansen is 1639779523. It was assigned to this individual provider in the NPPES registry on October 29, 2020. The provider is also known as Tracie Lyn Burrup.

Where is Tracie Hansen located?

Tracie Hansen practices at 560 Fairway Dr, Pocatello, ID 83201. The listed phone number is (208) 242-6669.

What is Tracie Hansen's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Tracie Hansen was last updated on October 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.