Healthcare Provider Details

I. General information

NPI: 1881032225
Provider Name (Legal Business Name): TRACEY M BRATTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1693 HWY 425 S
MONTICELLO AR
71655
US

IV. Provider business mailing address

215 E SHELTON AVE
MONTICELLO AR
71655-4939
US

V. Phone/Fax

Practice location:
  • Phone: 870-723-5832
  • Fax:
Mailing address:
  • Phone: 870-723-5832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7249-C
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: