# TRACY GILLOCK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1407678659
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | CTB-2026-0362 | NM | Yes |
| 172V00000X | Community Health Worker | — | NM | — |
| 175T00000X | Peer Specialist | 1843 | NM | — |

## Other

- **Enumeration date:** 10/29/2024
- **Last updated:** 05/22/2026