Provider Demographics
NPI:1700822954
Name:LOVE CHANDLER, TRACYE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TRACYE
Middle Name:
Last Name:LOVE CHANDLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-2421
Mailing Address - Country:US
Mailing Address - Phone:918-810-6852
Mailing Address - Fax:
Practice Address - Street 1:616 S BOSTON AVE STE 302
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-1210
Practice Address - Country:US
Practice Address - Phone:918-829-3581
Practice Address - Fax:918-380-0096
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
OK2466101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)