TRACY HUMPHREY CIT
NPI 1750762969
Counselor - Addiction (Substance Use Disorder) in Russellville, AR
Active since June 12, 2015
About Tracy Humphrey Cit NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TRACY HUMPHREY CIT (NPI 1750762969) is an individual addiction (substance use disorder) provider in Russellville, Arkansas and active in the NPI registry since June 2015.
NPPES Registry Identity
NPI1750762969
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameTRACY HUMPHREYCredential: CIT
Location Address400 LAKE FRONT DRRussellville, AR 72802-2206
Mailing AddressPo Box 1463Russellville, AR 72811-1463 · (479) 968-7086 · Fax (479) 968-7225
Phone(479) 968-7086
Fax(479) 968-4331
Sole ProprietorYes
Enumeration DateJune 12, 2015
✔ NPI 1750762969 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
400 LAKE FRONT DR, Russellville, AR 72802
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Counselor (Addiction (Substance Use Disorder))
400 LAKE FRONT DR
RUSSELLVILLE, AR 72802
RUSSELLVILLE, AR 72802
Family Medicine (Addiction Medicine)
400 LAKE FRONT DR
RUSSELLVILLE, AR 72802
RUSSELLVILLE, AR 72802
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750762969, enumerated as an "individual" on June 12, 2015.
The provider is located at 400 LAKE FRONT DR RUSSELLVILLE, AR 72802 and the phone number is (479) 968-7086.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
