Individual provider Active NPI

Tracey A. Chance, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1184899239
Registry record updated Oct 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
30286 Issued in TX
Practice address
6507 Clubway LN
Austin, TX 78745-3726
Phone
(512) 441-0208
NPI assigned
Apr 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2009

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 30286 TX Primary

Addresses

Primary practice location

6507 Clubway LN
Austin, TX 78745-3726

Mailing address

6507 Clubway LN
Austin, TX 78745-3726
Phone (512) 441-0208

Other names 1

  • Tracey Ann Caldwell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100211000753 TX Practitioner - Clinical Social Worker 4981747060 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Travis County Mental Health and Mental Retardation Center CurrentSince Nov 4, 2019 Accepting new patients
Austin Travis County Mental Health and Mental Retardation Center Clinical CurrentSince Nov 4, 2019 Accepting new patients

Locations

825 E Rundberg Ln
#F
Austin, TX 78753
Phone (512) 804-3900

5015 S Interstate 35
Austin, TX 78744
Phone (512) 703-1392

1430 Collier St
Austin, TX 78704
Phone (512) 427-4357

Organizations & group practices 2

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": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255392000000",
    "number": "1184899239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 CLUBWAY LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787453726",
            "telephone_number": "512-441-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 CLUBWAY LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787453726",
            "telephone_number": "512-441-0208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANCE",
        "first_name": "TRACEY",
        "middle_name": "A.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-29",
        "last_updated": "2009-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "30286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "CALDWELL",
            "middle_name": "ANN",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.