MR. JACK FRANK TRACY PH.D. NPI 1609089655

NPI Information

NPI: 1609089655
Provider Name: MR. JACK FRANK TRACY, PH.D.
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
1006 24TH AVE NW STE 100
NORMAN, OK
ZIP 73069
Phone: (405) 801-2836
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MR. Jack Frank Tracy, PH.D. is a mental health counselor in Norman, OK with 15 years of experience. MR. Jack Frank Tracy, PH.D. NPI is 1609089655. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Graduation Year:2009

The provider's business location address is:

1006 24TH AVE NW STE 100
NORMAN, OK
ZIP 73069-344
Phone: (405) 801-2836
Fax: (405) 801-2846

The NPI 1609089655 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 5/7/2007 and was last updated on 2/9/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103T00000X	Psychologist		1120	OKLAHOMA	No
2	101YM0800X	Counselor	Mental Health	3829	OKLAHOMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	OKAAA2310	MEDICARE UPIN	OKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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