Adevai, Tracy Renee

Adevai, Tracy Renee is an sole proprietor health care provider with primary practice located at 285 Se Fowler St , Roseburg OR 97470-3337. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Adevai, Tracy Renee can be contacted via phone (541) 671-5185.

Contact Information

Primary practice address
285 Se Fowler St Roseburg OR 97470-3337
Phone: (541) 671-5185
Fax: (541) 230-2575
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 1041C0700X L10899 Oregon

Profile Details

NPI number 1740698471
LBN Legal business name Adevai, Tracy Renee
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 25th, 2014
Last updated Mar 2nd, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740698471 NPPES
Oregon MEDICAID 500685947

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