Provider Demographics
NPI:1760368088
Name:ARMSTRONG, TRACY BRONSON
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:BRONSON
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 OAK GROVE RD
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-5527
Mailing Address - Country:US
Mailing Address - Phone:409-594-7740
Mailing Address - Fax:
Practice Address - Street 1:1924 OAK GROVE RD
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-5527
Practice Address - Country:US
Practice Address - Phone:409-594-7740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94546101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional