Tracey Middleton Jennings, MSW, LCSW, LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

8937 S Garnett Rd
Broken Arrow, OK 74012-6004

Phone

(918) 872-9777

Fax

(918) 872-9779

NPI assigned

May 12, 2010

Last updated

Jul 12, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tracey M. Jennings, LCSW, LLC

  • Clinical Social Worker
  • Tulsa, OK
  • NPI 1376128702
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1124346317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 N SIOUX AVE",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173700",
            "telephone_number": "918-342-2622",
            "fax_number": "918-342-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8937 S GARNETT RD",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740126004",
            "telephone_number": "918-872-9777",
            "fax_number": "918-872-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "TRACEY",
        "middle_name": "MIDDLETON",
        "credential": "MSW, LCSW, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": "1033",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "3963",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "3963",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey L. Halford, DO, PLLC
• Tracy Jeffrey
• Shaina Jemmott
• Traci Jennings-Harkey
• Beau Charles Jennings, DO
• Ryan Jensen, DPT
• Leroy O. Jeske, D.O.
• Emerson Taylor Jewart
• Catherine Grace Jezek, COTA/L
• Luis Alfonse Jimenez Rincon

• Clinical Social Worker in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.