Individual provider Active NPI

Tracey Lynn Wheeler, LMSW

  • Clinical Social Worker
  • Gaylord, MI
National Provider Identifier
1003442674
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801117027 Issued in MI
Practice address
829 W Main St Ste 3
Gaylord, MI 49735-1998
Phone
(989) 732-6761
NPI assigned
Mar 16, 2020
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Clinical Social Worker 1041C0700X 6801117027 MI Primary

Addresses

Primary practice location

829 W Main St Ste 3
Gaylord, MI 49735-1998

Mailing address

PO Box 189
Mancelona, MI 49659-0189
Phone (989) 387-1734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230921003544 MI Practitioner - Clinical Social Worker 5496109639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Human Services, IncGroup PAC ID 4880586494, 14 clinicians

Practice addresses (Care Compare)

205 Grove St
Mancelona, MI 49659-8018
Phone (989) 732-6761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Human Services, Inc Addiction (Substance Use Disorder) CurrentSince Sep 15, 2023 Accepting new patients
Catholic Human Services Inc. CurrentSince Sep 15, 2023 Accepting new patients
Catholic Charities of Michigan Incorporated Past Accepting new patients

Locations

829 W Main St
Ste C3
Gaylord, MI 49735
Phone (989) 370-9129

205 Grove St
Mancelona, MI 49659
Phone (231) 587-5068

1000 Hastings St
Traverse City, MI 49686
Phone (231) 947-8110

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21307/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1003442674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "MANCELONA",
            "state": "MI",
            "postal_code": "496590189",
            "telephone_number": "989-387-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 W MAIN ST STE 3",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351998",
            "telephone_number": "989-732-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "TRACEY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-16",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801117027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaylord, MI

Sources for this page

Verify at the official NPI Registry.