Provider Demographics
NPI:1295592335
Name:HUFFMAN, TRACY JANEL (LMSW)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:JANEL
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:JANEL
Other - Last Name:SHATWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:825 HIGHWAY 71 N STE C
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:AR
Mailing Address - Zip Code:72921-5114
Mailing Address - Country:US
Mailing Address - Phone:479-322-9375
Mailing Address - Fax:
Practice Address - Street 1:825 HIGHWAY 71 N STE C
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:AR
Practice Address - Zip Code:72921-5114
Practice Address - Country:US
Practice Address - Phone:479-322-9375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR11234-M104100000X
AR11234-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker