Berg, Stacy Ann
Berg, Stacy Ann is an individual health care provider with primary practice located at 550 S Peoria Ave , Tulsa OK 74120-3820. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Other Service Providers / Health Educator. Other Service Providers / Health Educator is her primary health care specialty. Berg, Stacy Ann can be contacted via phone (918) 588-1900.Contact Information
Primary practice address
550 S Peoria Ave
Tulsa OK 74120-3820
Phone: (918) 588-1900
Fax: (918) 582-6405
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Professional | 101YP2500X | 3570 | Oklahoma |
Other Service Providers / Health Educator | 174H00000X | 21410447 | Oklahoma |
Profile Details
NPI number | 1396829065 |
---|---|
LBN Legal business name | Berg, Stacy Ann |
Credentials | Licensed Professional Counselor (LPC) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 25th, 2006 |
Last updated | Sep 21st, 2015 - about 10 years 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1396829065 | NPPES |
Oklahoma | MEDICAID | 200566570 A |
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