Individual provider Active NPI

Tracey Roberts, LCSW

  • Clinical Social Worker
  • Lawrenceville, GA
National Provider Identifier
1366333270
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004942 Issued in GA
Practice address
2775 Cruse Rd Ste 901
Lawrenceville, GA 30044-7143
Phone
(770) 925-2095
NPI assigned
Jul 10, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 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 CSW004942 GA Primary

Addresses

Primary practice location

2775 Cruse Rd Ste 901
Lawrenceville, GA 30044-7143

Mailing address

132 Gober Dr
Commerce, GA 30530-4384
Phone (770) 925-2095

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

LicenseStateTypeSpecialty
CSW004942GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Social Empowerment Center Clinical CurrentSince Jul 13, 2025 Accepting new patients

Locations

2775 Cruse Rd
Ste 901
Lawrenceville, GA 30044
Phone (203) 273-7063

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": "1752105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1366333270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 GOBER DR",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305304384",
            "telephone_number": "770-925-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 CRUSE RD STE 901",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300447143",
            "telephone_number": "770-925-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TRACEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.