Active NPI
Tracey Marie Mackinnon, MSW, LCSW
- Mental Health Counselor
- Plymouth, MA
National Provider Identifier
1427564236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 000223292
- Practice address
- 2 School St
Plymouth, MA 02360-3964 - Phone
- (508) 830-1234
- NPI assigned
- Dec 18, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 000223292 | MA | Primary |
Addresses
Primary practice location
2 School St
Plymouth, MA 02360-3964
Mailing address
2 School St
Plymouth, MA 02360-3964
Phone (508) 830-1234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201021000440 | MA | Practitioner - Clinical Social Worker | 9739509332 | Practice locations: Scituate, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
207 Front St
Suite 3
Scituate, MA 02066-1391
Phone (781) 424-9621
5 Bound Brook CT
Suite B1
Scituate, MA 02066-1236
Phone (781) 424-9621
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000223292 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513555200000",
"number": "1427564236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 SCHOOL ST",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023603964",
"telephone_number": "508-830-1234",
"fax_number": "508-830-1191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 SCHOOL ST",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023603964",
"telephone_number": "508-830-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKINNON",
"first_name": "TRACEY",
"middle_name": "MARIE",
"credential": "MSW, LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-18",
"last_updated": "2017-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "000223292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; 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.