Individual provider Active NPI

Tracy Lynn Edwards, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1295064129
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW6492 Issued in FL
Practice address
836 Prudential Dr Ste 1006
Jacksonville, FL 32207-8337
Phone
(904) 376-3800
NPI assigned
Dec 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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 SW6492 FL Primary

Addresses

Primary practice location

836 Prudential Dr Ste 1006
Jacksonville, FL 32207-8337

Mailing address

PO Box 748519
Atlanta, GA 30374-8519
Phone (904) 376-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211109003555 FL Practitioner - Clinical Social Worker 3971992199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Behavioral Health LLCGroup PAC ID 7315166394, 120 clinicians

Practice addresses (Care Compare)

836 Prudential Dr
Suite 1006
Jacksonville, FL 32207-8337
Phone (904) 376-3800

Merit-based Incentive Payment System (MIPS)

Final score
89.95 of 100Reported as group
Quality
84.69
Promoting interoperability
100
Improvement activities
40
Cost
74.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Behavioral Health, LLC CurrentSince Dec 5, 2021 Accepting new patients

Locations

836 Prudential Dr
Ste 1006
Jacksonville, FL 32207
Phone (904) 202-1795

820 Prudential Dr
Ste 510
Jacksonville, FL 32207

Organizations & group practices 1

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": "1261612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1295064129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748519",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748519",
            "telephone_number": "904-376-3800",
            "fax_number": "904-376-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 1006",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078337",
            "telephone_number": "904-376-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-24",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.