Jennings, Tracey Middleton

Jennings, Tracey Middleton is an sole proprietor health care provider with primary practice located at 8937 S Garnett Rd , Broken Arrow OK 74012-6004. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Jennings, Tracey Middleton can be contacted via phone (918) 872-9777.

Contact Information

Primary practice address
8937 S Garnett Rd Broken Arrow OK 74012-6004
Phone: (918) 872-9777
Fax: (918) 872-9779
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1033 Oklahoma
Behavioral Health & Social Service Providers / Clinical 1041C0700X 3963 Oklahoma

Profile Details

NPI number 1124346317
LBN Legal business name Jennings, Tracey Middleton
Credentials MSW, LCSW, LADC
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 12th, 2010
Last updated Jul 12th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124346317 NPPES
Oklahoma Other 3963 LICENSE

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