Tracey Roman McKiernan, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0700065 Issued in OH

Practice address

3737 Lander Rd
Pepper Pike, OH 44124-5712

Phone

(216) 831-2255

Fax

(216) 831-0638

NPI assigned

Aug 31, 2006

Last updated

Feb 23, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Catholic Charities Corporation

  dba Catholic Charities - Parmadale MH

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Euclid, OH
  • NPI 1972550010
  Medicare reassignment NPD
• New Center Community Mental Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Detroit, MI
  • NPI 1306864129
  NPD (past)
• New Center Community Mental Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Detroit, MI
  • NPI 1588672091
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1023129350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 LANDER RD.",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441241105",
            "telephone_number": "216-831-2255",
            "fax_number": "216-831-0638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 LANDER RD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245712",
            "telephone_number": "216-831-2255",
            "fax_number": "216-831-0638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIERNAN",
        "first_name": "TRACEY",
        "middle_name": "ROMAN",
        "name_prefix": "Mrs.",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801078204",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "0700065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "6801078204",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James McCann III
• Daniel Carl Martin McCormick II
• Candace A McCown, LISW-S
• Michael McGraw
• Caise R McHale, LSW
• Kimberlyn Mae Meyer, PCC-S
• Kate Michaels
• Miller Drug Store
• Jeffrey Miller, LSW
• Noah L Miller, MD

• Clinical Social Worker in Pepper Pike, OH
• Providers in Pepper Pike, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.