Provider Demographics
NPI:1619794955
Name:TRACY ALBRIGHT LCSW LADC PLLC
Entity type:Organization
Organization Name:TRACY ALBRIGHT LCSW LADC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW/LADC
Authorized Official - Phone:405-719-9862
Mailing Address - Street 1:1975 PLEASANT RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-3294
Mailing Address - Country:US
Mailing Address - Phone:405-719-9862
Mailing Address - Fax:
Practice Address - Street 1:1975 PLEASANT RIDGE CT
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-3294
Practice Address - Country:US
Practice Address - Phone:405-719-9862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty