Hattie M Tracy, LISW, LCDCIII

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I.0900274 Issued in OH

Practice address

4209 State Route 44
Rootstown, OH 44272-9698

Phone

(330) 325-6697

Fax

(330) 325-5970

NPI assigned

Apr 16, 2007

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 names 1

• Hattie M Tracy-Kramer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1043435944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 STATE ROUTE 44",
            "city": "ROOTSTOWN",
            "state": "OH",
            "postal_code": "442729698",
            "telephone_number": "330-325-6697",
            "fax_number": "330-325-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 STATE ROUTE 44",
            "city": "ROOTSTOWN",
            "state": "OH",
            "postal_code": "442729698",
            "telephone_number": "330-325-6697",
            "fax_number": "330-325-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "HATTIE",
        "middle_name": "M",
        "credential": "LISW, LCDCIII",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.0900274",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "081003",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HATTIE",
            "last_name": "TRACY-KRAMER",
            "middle_name": "M",
            "credential": "LISW,LCDCIII",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cory A Tepus
• The Tamarkin Company
• Tiffany Christine Thomas-Lakia, M.D.
• Michelle Lea Tobias, APRN, CNP
• Township of Edinburg Trustees
• Timothy Robert Ulbrich
• Cynthia C Uzoukwu
• Joshua Thomas Vogt
• Katherine Voytkiv
• Michelle Ann Walter, LPN

• Social Worker in Rootstown, OH
• Providers in Rootstown, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.