TRACEY CLARK (LPC) – Mental Health Counselor, NPI 1215479415
Mental Health Counselor
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,207 MENTAL HEALTH COUNSELOR in CO
Provider Addresses for TRACEY CLARK (LPC)
1840 Woodmoor Dr Ste 102
Monument, CO 801329083
Phone: (719) 622-6522
Type: Location
1295 Kelly Johnson Blvd Ste 100
Colorado Springs, CO 809203978
Phone: (719) 622-6522
Type: Location
1259 Lake Plaza Dr Ste 200
Colorado Springs, CO 809063516
Phone: (719) 622-6522
Type: Location
65, Waltham Avenue, Manitou Springs, El Paso County, Colorado, 80829, United States
MANITOU SPRINGS, CO 808291612
Phone:
Type: Mailing
110 E ROUTT AVE
PUEBLO, CO 810042117
Phone: (719) 543-8711
Fax: (719) 543-0171
Type: Mailing
300 COLORADO AVE
PUEBLO, CO 810042006
Phone: (719) 543-8711
Fax: (719) 543-0171
Type: Location
1840 WOODMOOR DR STE 102
MONUMENT, CO 801329083
Phone: (719) 622-6522
Type: Mailing
8580 SCARBOROUGH DR STE 125
COLORADO SPRINGS, CO 809207584
Phone: (719) 622-6522
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-12-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231211001558 | I | Mental Health Counselor | CO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 80132)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | CO | |
| Emergency Medicine | OH | |
| Physician Assistant | CO | |
| Physician Assistant | CO | |
| Mental Health Counselor | CO | |
| Nurse Practitioner | CO | |
| Mental Health Counselor | CO | |
| Physician Assistant | CO | |
| Marriage And Family Therapist | CO |
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