Tracy Philesia Hollingsworth, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

091116 Issued in NY

Practice address

65 Olde Colonial Dr Apt 2
Gardner, MA 01440-4216

Phone

(917) 837-6797

NPI assigned

Apr 5, 2021

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

Other names 1

• Tracy Philesia Hollingsworth Professional name

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

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.

• Arck Nurse Practitioner in Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hauppauge, NY
  • NPI 1700464682
  Medicare reassignment NPD

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1417536665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 OLDE COLONIAL DR APT 2",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014404216",
            "telephone_number": "917-837-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 OLDE COLONIAL DR APT 2",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014404216",
            "telephone_number": "917-837-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINGSWORTH",
        "first_name": "TRACY",
        "middle_name": "PHILESIA",
        "name_prefix": "Miss",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "HOLLINGSWORTH",
            "middle_name": "PHILESIA",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Barbara Hietala
• Elizabeth D Higgins-Steele, M.ED.
• Ava Grace Hill
• Sarah Hine
• Kristin Leigh Holdom, OTR/L
• Erika Amelia Holm
• Holy Trinity Homecare LLC
• Home Town Wellness, LLC
• Homelink Health LLC
• Ellen Scagel Honsa, LMHC

• Clinical Social Worker in Gardner, MA
• Providers in Gardner, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.