| Tracey M. Jennings, Lcsw, Llc | |
|
8516 E 101st St Ste E Tulsa OK 74133-7035 | |
| (918) 902-3848 | |
| Not Available |
| Full Name | Tracey M. Jennings, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 8516 E 101st St Ste E, Tulsa, Oklahoma |
| Authorized Official Name and Position | Tracey M Jennings (PRESIDENT) |
| Authorized Official Contact | 9188521286 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracey M. Jennings, Lcsw, Llc 8516 E 101st St Ste E Tulsa OK 74133-7035 Ph: (918) 902-3848 | Tracey M. Jennings, Lcsw, Llc 8516 E 101st St Ste E Tulsa OK 74133-7035 Ph: (918) 902-3848 |
| NPI Number | 1376128702 |
|---|---|
| Provider Enumeration Date | 03/17/2021 |
| Last Update Date | 03/17/2021 |
| Certification Date | 03/17/2021 |
| Medicare PECOS PAC ID | 0244648244 |
|---|---|
| Medicare Enrollment ID | O20210419000339 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376128702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tracey M Jennings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124346317 PECOS PAC ID: 6103110028 Enrollment ID: I20160815002889 |
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