Individual provider Active NPI

Tracey Tillinghast, LICSW

  • Clinical Social Worker
  • Warwick, RI
National Provider Identifier
1093034381
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW02714 Issued in RI
Practice address
300 Toll Gate Rd
Warwick, RI 02886-4416
Phone
(401) 785-0040
NPI assigned
May 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW02714 RI Primary

Addresses

Primary practice location

300 Toll Gate Rd
Warwick, RI 02886-4416

Mailing address

300 Toll Gate Rd
Warwick, RI 02886-4416
Phone (401) 785-0040

Other identifiers 2

IdentifierTypeStateIssuer
ISW02714OtherRIDEPARTMENT OF HEALTH
GH57134MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20160204000273 RI Practitioner - Clinical Social Worker 2365746815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Child and Family Psychiatry, Inc.Group PAC ID 5294173464, 90 clinicians

Practice addresses (Care Compare)

300 Toll Gate Rd
Suite 300
Warwick, RI 02886-4416
Phone (401) 467-0333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW02714RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychiatry, Inc. Clinical CurrentSince Jul 23, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

1035 Post Rd
Warwick, RI 02888
Phone (401) 941-2830

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1093034381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864416",
            "telephone_number": "401-785-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864416",
            "telephone_number": "401-785-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLINGHAST",
        "first_name": "TRACEY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-26",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH",
            "identifier": "ISW02714",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GH57134",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.