Tracy, Jacob Kenneth
Tracy, Jacob Kenneth is an sole proprietor health care provider with primary practice located at 410 E Lake Street Suite 100, Petoskey MI 49770. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Tracy, Jacob Kenneth can be contacted via phone (616) 889-4104.Contact Information
Primary practice address
410 E Lake Street Suite 100
Petoskey MI 49770
Phone: (616) 889-4104
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 6401015019 | Michigan |
Profile Details
| NPI number | 1720585037 |
|---|---|
| LBN Legal business name | Tracy, Jacob Kenneth |
| Credentials | LPC, NCC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 12th, 2018 |
| Last updated | Apr 12th, 2018 - about 6 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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