Organization
TRACIE JOHNSON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE BREN-CLEGG LPC-MH (OWNER / CEO)
(605) 641-7534
Entity
Organization
Contact information
Practice address
211 N MAIN ST STE 203, SPEARFISH, SD 57783-2646
(605) 641-7534
(605) 559-0512
Mailing address
211 N MAIN ST STE 203, SPEARFISH, SD 57783-2646
(605) 641-7534
(605) 559-0512
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
07/16/2017
Last updated
09/29/2020
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