Look up the most recent NPI and PECOS records

Tracy Small

Marriage & Family Therapist

Behavioral Health & Social Service Providers

12625 Hesperia Rd, Victorville, CA 92395-7720

PECOS Enrollment

Based on the most recent information from CMS, provider Tracy Small does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1730564717
Provider Type
Individual
Full Name
Small, Tracy
Credential
AMFT APCC

Gender
Male
Sole Proprietor
No
Enumeration Date
7/20/2015
Last Updated
9/26/2024

Contact Information

Practice Location

12625 Hesperia Rd, Victorville, CA 92395-7720

(760) 995-8385

Unlisted Fax

Mailing Location

12127 Mall Blvd Ste A115, Victorville, CA 92392-7665

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 106S00000X	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer

Tracy Small

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Hemphill, Jennifer N

Callahan, Mark

Redman, Tamesia Michele

Clair, Dona J

Johnson, Kasha M

Barbieri, Joanne C.

Jones, Beverly

Bray, Craig

Green, Mercedes D

Hermosillo, Adriana