Individual provider Active NPI

Tracy R Henningsen

  • Clinical Social Worker
  • Tallahassee, FL
National Provider Identifier
1386589844
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW22149 Issued in FL
Practice address
1363 E Lafayette St
Tallahassee, FL 32301-4799
Phone
(850) 926-1900
NPI assigned
Apr 21, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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 SW22149 FL Primary

Addresses

Primary practice location

1363 E Lafayette St
Tallahassee, FL 32301-4799

Mailing address

1279 Cordova Cir
Tallahassee, FL 32317-8480
Phone (850) 294-6341

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
I20260617004740 FL Practitioner - Clinical Social Worker 3870065188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2140 Crawfordville Hwy
Unit B
Crawfordville, FL 32327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW22149FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A Time to Change Counseling Center Clinical CurrentSince Jun 1, 2026 Accepting new patients
A Time to Change Counseling Center CurrentSince Jun 1, 2026 Accepting new patients

Locations

1363 E Lafayette St
Tallahassee, FL 32301
Phone (850) 296-1900

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": "1776729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1386589844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1279 CORDOVA CIR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323178480",
            "telephone_number": "850-294-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1363 E LAFAYETTE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323014799",
            "telephone_number": "850-926-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNINGSEN",
        "first_name": "TRACY",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-21",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW22149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.