Tracy J Waible, LCSW, LCAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34006088A Issued in IN

Practice address

5638 Professional Cir
Indianapolis, IN 46241-5042

Phone

(317) 247-8900

Fax

(317) 247-8935

NPI assigned

Sep 28, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tracy J Garrett Other name

Medicare fee-for-service enrollment

Enrolled in IN

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

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.

• Cummins Behavioral Health Systems, Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Avon, IN
  • NPI 1740232115
  Medicare reassignment

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

{
    "created_epoch": "1380326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1134556640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 E US HIGHWAY 36 STE 100",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461236646",
            "telephone_number": "888-714-1927",
            "fax_number": "317-745-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5638 PROFESSIONAL CIR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462415042",
            "telephone_number": "317-247-8900",
            "fax_number": "317-247-8935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAIBLE",
        "first_name": "TRACY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "LCSW, LCAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-28",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006088A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "GARRETT",
            "middle_name": "J",
            "credential": "LCSW, LCAC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Trent P Wagoner, CAA
• Saira Zakir Waheed, MD
• Brenda J. Wahl, O.D.
• Ethan Wahl, PHARMD
• Janice H Wahman, LCSW, LMHC
• Flevis Fujua Waindim
• Abigail N Wainman, MSW, LCSW
• Aaron Elijah Waire, MA
• Beth A Waite, CCC-SLP
• Carly Michelle Waite

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; 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.