DR. TRACIE MERTZ MCCONNELL (NPI# 1003968116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003968116 |
| Entity Type | Individual |
| Full Name | DR. TRACIE MERTZ MCCONNELL |
| Other Name | DR. TRACIE L. MERTZ |
| Credential | PHD |
| Practice Address |
651 S Main St Greenville SC 29601-2504 |
| Mailing Address |
255 Enterprise Blvd Suite 250 Greenville SC 29615-6300 |
| Practice Telephone | 8642412600 |
| Practice Fax Number | 8644541130 |
| Mailing Telephone | 8644540888 |
| Mailing Fax Number | 8644541130 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2012-01-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 686 | SC | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | 686 | SC | Behavioral Health & Social Service Providers |
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
686 | SC | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
686 | SC | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
686 | SC | Behavioral Health & Social Service Providers |
| N | 103TH0100X |
Psychologist Specialization: Health Service |
686 | SC | Behavioral Health & Social Service Providers |
| N | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
686 | SC | Behavioral Health & Social Service Providers |
| N | 103TR0400X |
Psychologist Specialization: Rehabilitation |
686 | SC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | PS0262 | 05 | |
| SC | MEDICARE RAILROAD | 680016185 | 01 |
| Street Address |
651 S MAIN ST |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29601-2504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013060813 | Craig Douglas Young | Clinical Neuropsychologist | 651 S Main St, Greenville, SC 29601-2504 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700305620 | True Sleep Diagnostics | Clinic/Center | 220 North Main St Ste 500, Pmb 104, Greenville, SC 29601 | 2017-09-12 |
| 1245786813 | Yvette Ombougno | Registered Nurse | 200 University Ridge, Greenville, SC 29601 | 2016-09-01 |
| 1477921823 | Laura Gore Siefert | Registered Nurse | 1 Saint Francis Drive, Greenville, SC 29601 | 2015-09-02 |
| 1821493826 | Sarah Fuller | Counselor | 602 Pettigru St, Greenville, SC 29601 | 2014-11-03 |
| 1689088932 | Chenille Taylor | Nurse Practitioner | 201 N. Main Street, Greenville, SC 29601 | 2014-06-15 |
| 1861827842 | Caritas Counseling Services LLC | Community/Behavioral Health | 111 Hampton Avenue, St Mary's Catholic Church, Greenville, SC 29601 | 2013-09-09 |
| 1568790335 | Lynn A. Victory | Counselor | 710 Pettigru Street, The Cottage, Greenville, SC 29601 | 2009-12-06 |
| 1386971448 | Lisa Speach | Nurse Practitioner | 3 St. Francis Drive, Suite 300, Greenville, SC 29601 | 2009-11-11 |
| 1851528418 | Adam Shawn Riffle | Specialist/Technologist | 175 Patewood Drive, Greenville, SC 29601 | 2009-06-22 |
| 1114178332 | Margaret W. Lee | Psychologist | 412 Pettigru St., Suite C, Greenville, SC 29601 | 2008-10-07 |
| Find all providers in zip 29601 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639278567 | Brian J. Yore | Clinical Neuropsychologist | 214 Roper Mountain Road Ext, Greenville, SC 29615-4825 | 2006-09-21 |
| 1265485437 | Daniel Erik Everhart | Clinical Neuropsychologist | 219 Commerce St, Suite B, Greenville, NC 27858-5035 | 2006-05-18 |
| 1750382388 | Gregory L. Duncan | Clinical Neuropsychologist | 905 Johns Hopkins Drive, Greenville, NC 27834-7225 | 2005-08-04 |
| 1376192641 | Maria Jay Mcdaniel | Clinical Neuropsychologist | 1350 Cleveland St, Greenville, SC 29607-2440 | 2019-09-09 |
| 1437545373 | Joseph Kent Hammond | Clinical Neuropsychologist | 100 Augusta St, Greenville, SC 29601-3504 | 2015-04-07 |
| 1447529169 | Carolyn Elizabeth Prince | Clinical Neuropsychologist | 701 Grove Rd, Greenville, SC 29605-4210 | 2011-12-26 |
| 1548582596 | East Carolina Neurology | Clinical Neuropsychologist | 2280 Hemby Ln, Greenville, NC 27834-3773 | 2010-02-18 |
| 1437389343 | Melissa Ivey Phillips | Clinical Neuropsychologist | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2009-07-27 |
| 1245471713 | James Roger Evans | Clinical Neuropsychologist | 1200 Woodruff Rd, Building A-3, Greenville, SC 29607-5730 | 2009-03-13 |
| 1407900632 | Rebecca Wagner | Clinical Neuropsychologist | 100 Augusta St, Greenville, SC 29601-3504 | 2007-01-23 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29601 |
Please comment or provide details below to improve the information on DR. TRACIE MERTZ MCCONNELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.