Tracy Amanda Waddle in North Little Rock - Clinical
Tracy Amanda Waddle - NPI 1881708600
Tracy Amanda Waddle is a Clinical in North Little Rock, Arkansas. Tracy Amanda Waddle practices all healthcare services and medical treatments related to Clinical. The NPI Number for Tracy Amanda Waddle is 1881708600. The last update date is 2007-07-08.
Tracy Amanda Waddle's current location address is 4354 Stockton Dr, North Little Rock, Arkansas. You can contact this provider via phone number 5019557600 and fax number 5019557612. The mailing address for Tracy Amanda Waddle is 4354 Stockton Dr, North Little Rock, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tracy Amanda Waddle |
|---|---|
| Address | 4354 Stockton Dr, North Little Rock, Arkansas |
| Phone Number | 5019557600 |
| Fax Number | 5019557612 |
| Sole Proprietor | N |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1881708600 |
|---|---|
| Provider Enumeration Date | 2006-08-18 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 4354 Stockton Dr |
|---|---|
| City | North Little Rock |
| State | Arkansas (AR) |
| Post Code | 721172917 |
| Phone Number | 5019557600 |
| Fax Number | 5019557612 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 2017-C |
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Definition: 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, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5Y892 | AR | ARKANSAS BCBS |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Tracy Amanda Waddle by the Centers for Medicare & Medicaid Services?
The Tracy Amanda Waddle has been issued the NPI (National Provider Identifier) 1881708600 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Tracy Amanda Waddle is physically located?
The Tracy Amanda Waddle is physically situated at the following address: 4354 Stockton Dr, North Little Rock, AR, 721172917.
What is the area of specialization for Tracy Amanda Waddle, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Tracy Amanda Waddle is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 1041C0700X.
On what date did the Tracy Amanda Waddle receive the assignment of its 1881708600 from the Centers for Medicare & Medicaid Services?
The Tracy Amanda Waddle was issued its 1881708600 by the Centers for Medicare & Medicaid Services on 2006-08-18.
As of what date were the details related to Tracy Amanda Waddle most recently updated or revised?
The information pertaining to Tracy Amanda Waddle, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
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