Traci Lee Phillips-Perkins, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R073014-1 Issued in NY

Practice address

453 Dixon Rd
BLDG. 3 Ste. 8
Queensbury, NY 12804-1949

Phone

(518) 420-7466

Fax

(518) 745-5731

NPI assigned

May 10, 2011

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 NY

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

State University of New York at Buffalo School of Medicine, 2002

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

Locations

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.

• Adirondack Counseling Traci Phillips LCSW PLLC

  • Clinical Social Worker
  • Queensbury, NY
  • NPI 1548964745
  Medicare reassignment NPD

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1295027217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4176",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128040176",
            "telephone_number": "518-420-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 DIXON RD",
            "address_2": "BLDG. 3 STE. 8",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041949",
            "telephone_number": "518-420-7466",
            "fax_number": "518-745-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS-PERKINS",
        "first_name": "TRACI",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-10",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R073014-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Pennington, RN
• Elizabeth Anne Petraccione, PT, DPT
• Douglas M Petroski, M.D.
• Anthony J. Pettinelli, CASAC-T
• Stacey Pfoh, LMSW
• Abigail Philpott, OTR/L
• Dennis J Picano, MD
• Dominique Suzanne Pickering, SLP
• Cheryl Pierce, SLP
• Debra Jean Pietrangelo, PSYD.

• Clinical Social Worker in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.