Provider Demographics
NPI:1568498988
Name:BATTEN, TRACY M (MS LPC LMHC)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:M
Last Name:BATTEN
Suffix:
Gender:F
Credentials:MS LPC LMHC
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:M
Other - Last Name:KENEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:PO BOX 1128
Mailing Address - Street 2:CAPITAL REGION PSYCHOLOGY AND COUNSELING
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65102-1128
Mailing Address - Country:US
Mailing Address - Phone:573-632-5560
Mailing Address - Fax:573-632-5875
Practice Address - Street 1:1432 SOUTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-2444
Practice Address - Country:US
Practice Address - Phone:573-632-5560
Practice Address - Fax:573-632-5875
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005025559101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO723908OtherHEALTHLINK
MOBCBS201378OtherBCBS