Individual
MR. TRACY LANE FUCHS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMHC, ASUDC
Contact information
Practice address
145 S 200 E, LINDON, UT 84042-2047
(801) 784-9455
(888) 876-2112
Mailing address
54 W 1200 N, OREM, UT 84057-2607
(801) 301-9703
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3083074-6008
UT
101YM0800X
Mental Health Counselor
Primary
3083074-6004
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3083074-6004
DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSING
UT
01
—
3083074-6008
DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSING
UT
Enumeration date
12/26/2017
Last updated
12/26/2017
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