Wathen, Tracy Monique

Wathen, Tracy Monique is an individual health care provider with primary practice located at 107 Cranes Roost Ct , Elizabethtown KY 42701-3650. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wathen, Tracy Monique can be contacted via phone (270) 765-2605.

Contact Information

Primary practice address
107 Cranes Roost Ct Elizabethtown KY 42701-3650
Phone: (270) 765-2605
Fax: (270) 234-8572
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 252190 Kentucky

Profile Details

NPI number 1861535635
LBN Legal business name Wathen, Tracy Monique
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2007
Last updated Aug 19th, 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 1861535635 NPPES
Kentucky MEDICAID 30605018

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