Active NPI
Tracy Lynn Casey, LCSW
- Clinical Social Worker
- Worcester, MA
National Provider Identifier
1174769798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 215093
- Practice address
- 275 Belmont St
Worcester, MA 01604-1675 - Phone
- (508) 421-4466
- Fax
- (508) 795-1338
- NPI assigned
- Jan 2, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Clinical Social Worker | 1041C0700X | 215093 | MA | Primary |
Addresses
Primary practice location
275 Belmont St
Worcester, MA 01604-1675
Mailing address
275 Belmont St.
Worcester, MA 01604-1937
Phone (508) 421-4466
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306421 | Medicaid | MA | |
| M18684 | Other | MA | BCBS |
| 1308785 | Medicaid | MA |
Other names 1
- Miss Tracy Lynn Nickerson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 215093 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353369600000",
"number": "1174769798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 BELMONT ST.",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016041937",
"telephone_number": "508-421-4466",
"fax_number": "508-795-1338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 BELMONT ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016041675",
"telephone_number": "508-421-4466",
"fax_number": "508-795-1338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASEY",
"first_name": "TRACY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-02",
"last_updated": "2012-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "215093",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306421",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "M18684",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1308785",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TRACY",
"last_name": "NICKERSON",
"middle_name": "LYNN",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.