Berg, Stacy Ann

Berg, Stacy Ann is an individual health care provider with primary practice located at 550 S Peoria Ave , Tulsa OK 74120-3820. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Other Service Providers / Health Educator. Other Service Providers / Health Educator is her primary health care specialty. Berg, Stacy Ann can be contacted via phone (918) 588-1900.

Contact Information

Primary practice address
550 S Peoria Ave Tulsa OK 74120-3820
Phone: (918) 588-1900
Fax: (918) 582-6405
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 3570 Oklahoma
Other Service Providers / Health Educator 174H00000X 21410447 Oklahoma

Profile Details

NPI number 1396829065
LBN Legal business name Berg, Stacy Ann
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2006
Last updated Sep 21st, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396829065 NPPES
Oklahoma MEDICAID 200566570 A

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