Individual provider Active NPI

Tracy L McCafferty, LCSW

  • Clinical Social Worker
  • Northbrook, IL
National Provider Identifier
1114199767
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
666 Dundee Rd
1504
Northbrook, IL 60062-2727
Phone
(847) 476-1532
Fax
(847) 509-1532
NPI assigned
Mar 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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 IL Primary

Addresses

Primary practice location

666 Dundee Rd
1504
Northbrook, IL 60062-2727

Mailing address

842 Western Ave
Northbrook, IL 60062-3449
Phone (847) 476-1532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 13, 2024 through Dec 13, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.007270ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1114199767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 WESTERN AVE",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600623449",
            "telephone_number": "847-476-1532",
            "fax_number": "847-509-1532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 DUNDEE RD",
            "address_2": "1504",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622727",
            "telephone_number": "847-476-1532",
            "fax_number": "847-509-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAFFERTY",
        "first_name": "TRACY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.