TRACEY MIDDLETON JENNINGS (NPI# 1124346317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124346317 |
| Entity Type | Individual |
| Full Name | TRACEY MIDDLETON JENNINGS |
| Credential | MSW, LCSW, LADC |
| Practice Address |
8937 S Garnett Rd Broken Arrow OK 74012-6004 |
| Mailing Address |
2990 N Sioux Ave Claremore OK 74017-3700 |
| Practice Telephone | 9188729777 |
| Practice Fax Number | 9188729779 |
| Mailing Telephone | 9183422622 |
| Mailing Fax Number | 9183422641 |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2016-07-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1033 | OK | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
3963 | OK | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | LICENSE | 3963 | 01 |
| Street Address |
8937 S GARNETT RD |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74012-6004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003846742 | Maria Arquisola | Psychiatry & Neurology | 8937 S Garnett Rd, Broken Arrow, OK 74012-6004 | 2006-07-04 |
| 1639665482 | Carrol Smith | Student in an Organized Health Care Education/Training Program | 8937 S Garnett Rd, Broken Arrow, OK 74012-6018 | 2018-07-05 |
| 1467793612 | Kimberly Oman | Nurse Practitioner | 8937 S Garnett Rd, Broken Arrow, OK 74012-6004 | 2013-03-13 |
| 1457691313 | Scott Rainwater | Psychologist | 8937 S Garnett Rd, Broken Arrow, OK 74012-6004 | 2013-02-28 |
| 1043512064 | Teresa Jo Mcilroy | Physical Therapist | 8937 S Garnett Rd, Broken Arrow, OK 74012-6004 | 2010-11-23 |
| 1750619334 | Lori Colleen Miller | Psychiatry & Neurology | 8937 S Garnett Rd, Broken Arrow, OK 74012-6004 | 2009-11-19 |
| 1326283466 | Dennis Charles Crookedacre | Counselor | 8937 S Garnett Rd, Broken Arrow, OK 74012-6004 | 2008-12-03 |
| 1467614248 | Tamara C Newcomb | Psychologist | 8937 S Garnett Rd, Broken Arrow, OK 74012 | 2008-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949139 | Bonnie Jordan James | Pharmacist | 915 E Kenosha St, Broken Arrow, OK 74012 | 2020-07-07 |
| 1548814874 | Flawless Smile Dentistry of Ba Pllc | Dentist | 2319 N. 9th Street, Broken Arrow, OK 74012 | 2019-07-25 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1699262386 | Fulps Family Eye Care, LLC | Optometrist | 3300 S Aspen Ave Ste D, Broken Arrow, OK 74012 | 2018-04-18 |
| 1598284358 | Stephanie Sue Mcquarters | Clinical Medical Laboratory | 1840 South Lion Avenue, Broken Arrow, OK 74012 | 2017-09-13 |
| 1477072460 | Kama Rae Gettings | Nurse Practitioner | 4623 W. Kenosha St, Broken Arrow, OK 74012 | 2017-09-12 |
| 1689196727 | Kristen Sherie' Snyder | Case Manager/Care Coordinator | 1324 North Umbrella Avenue, Broken Arrow, OK 74012 | 2017-07-11 |
| 1699216754 | Hillside Wellness Plllp | Chiropractor | 2311 N 9th St, Suite 101, Broken Arrow, OK 74012 | 2017-03-09 |
| Find all providers in zip 74012 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891260782 | Bonnie Nicholls | Social Worker | 860 S Aspen Ave, Broken Arrow, OK 74012-4803 | 2018-10-08 |
| 1770065930 | Sui Generis Counseling and Life Care Services, Pllc | Social Worker | 8304 S Kalanchoe Ave, Broken Arrow, OK 74011-7808 | 2018-09-05 |
| 1588159420 | Guadalupe Luis | Social Worker | 8000 E New Orleans St, Broken Arrow, OK 74014 | 2018-06-23 |
| 1699284026 | Morgan E Helms | Social Worker | 8200 E Madison St, Broken Arrow, OK 74014-7400 | 2017-09-28 |
| 1477922722 | Jayna Mayer | Social Worker | 1215 S Cypress Pl, Broken Arrow, OK 74012-6094 | 2015-09-16 |
| 1326449703 | A Bright Future Counseling Pllc | Social Worker | 2604 W Kenosha St, Suite 222, Broken Arrow, OK 74012-8956 | 2014-09-04 |
| 1598174096 | Traci Kane Anderson | Social Worker | 25198 Hickory Ln, Broken Arrow, OK 74014-3402 | 2014-08-08 |
| 1154751212 | Justin Brown | Social Worker | 1210 E Freeport St, Broken Arrow, OK 74012-2907 | 2013-11-26 |
| 1376893479 | Mary Frances Marrs | Social Worker | 9079 S 234th East Ave, Broken Arrow, OK 74014-3307 | 2012-09-16 |
| 1700153129 | Patty E. Poston | Social Worker | 6300 E Broadway St, Broken Arrow, OK 74014-6938 | 2011-11-30 |
| Find all providers in BROKEN ARROW | ||||
| City | BROKEN ARROW |
| Zip Code | 74012 |
Please comment or provide details below to improve the information on TRACEY MIDDLETON JENNINGS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.