Jack Tracy II, PH.D. Pyschological Services, PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1120 Issued in OK

Legal business name

JACK TRACY II, PH.D. PYSCHOLOGICAL SERVICES, PLLC

Practice address

1006 24TH Ave NW Ste 100
Norman, OK 73069-6344

Phone

(405) 801-2836

NPI assigned

Jan 28, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jack Frank Tracy II, PH.D.NPI 1609089655

Title

Licensed Psychologist

Phone

(405) 213-6130

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jack Frank Tracy II, PH.D.

  • Mental Health Counselor
  • Norman, OK
  • NPI 1609089655

  Psychologist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1457657165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 24TH AVE NW STE 100",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696344",
            "telephone_number": "405-801-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 24TH AVE NW STE 100",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696344",
            "telephone_number": "405-801-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK TRACY II, PH.D. PYSCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "TRACY",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "FRANK",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "405-213-6130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "OK",
            "license": "1120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Norman, OK
• Providers in Norman, OK by specialty
• Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.