Tracey Leeann Martin, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149012166 Issued in IL

Practice address

9200 W 191St St
Unit 6 Suite 1C
Mokena, IL 60448

Phone

(708) 690-8820

NPI assigned

May 17, 2007

Last updated

May 21, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Catholic Charities of the Diocese of Joliet

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kankakee, IL
  • NPI 1871984500
  NPD (past)
• Catholic Charities, Diocese of Joliet

  • Foster Care Agency
  • Kankakee, IL
  • NPI 1083932065
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526860800000",
    "number": "1194932962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17506 OAKWOOD DR",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604876128",
            "telephone_number": "815-207-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W 191ST ST",
            "address_2": "UNIT 6 SUITE 1C",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "60448",
            "telephone_number": "708-690-8820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "270 N Schuyler Ave",
            "address_purpose": "LOCATION",
            "city": "Kankakee",
            "state": "IL",
            "postal_code": "609013833",
            "country_code": "US",
            "telephone_number": "815-933-7791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TRACEY",
        "middle_name": "LEEANN",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2018-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marquette Eye and Vision Center, LLC
• Robert William Marquis, M.D.
• Laura Ann Martin, FNP
• Michele Marie Martin, APRN
• Patricia Martin, M S CCC SLP L
• Kara Marie Martino, M.S.
• Erika Matteucci
• Drew McCarthy, MOT, OTR/L
• Marybeth Ann McCarthy, FNP-BC
• Alma J. McCaskill

• Clinical Social Worker in Mokena, IL
• Providers in Mokena, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.