Tracy Marie Cooper, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.027850 Issued in IL

Practice address

34 W Grand Ave Ste 101
Fox Lake, IL 60020-1224

Phone

(585) 957-3981

NPI assigned

Dec 30, 2015

Last updated

Oct 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Bailey Behavioral Health LLCGroup PAC ID 0547681058, 4 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bailey Behavioral Health, PLLC

  • Professional Counselor
  • Fox Lake, IL
  • NPI 1790258408
  Medicare reassignment Care Compare group NPD
• Sheffer Psychological Services, PLLC

  • Clinical Psychologist
  • Libertyville, IL
  • NPI 1952809535
  NPD

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1447615729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 OAK RIDGE RD",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600121066",
            "telephone_number": "585-957-3981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 W GRAND AVE STE 101",
            "city": "FOX LAKE",
            "state": "IL",
            "postal_code": "600201224",
            "telephone_number": "585-957-3981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "TRACY",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.027850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Kathleen Buchanan, NCC, LPC
• CD&L Dental Associates, Inc.
• Ningyu Chen
• Daniel Choo, D.D.S.
• Christine Christopher
• Brian Creeron, OTD, OTR/L
• Daniel a Dohnalek DDS LTD (Manus Dental Fox Lake)
• Dental Professionals of Illinois, P.C. (Fox Lake Dental Care)
• Brianna N Dreschler, DPT
• Dynamic Hand Therapy & Rehabilitation Limited Partnership

• Clinical Social Worker in Fox Lake, IL
• Providers in Fox Lake, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.

Verify at the official NPI Registry.