Tracy Ellen Ambos, MSW, LCSW-C, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC303237 Issued in DC

Practice address

5100 Fetcher Avenue
Joint Base Andrews, MD 20762

Phone

(240) 612-7600

NPI assigned

Jan 13, 2016

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

Medicare fee-for-service enrollment

Enrolled in DC

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, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uplift Behavioral Health PCGroup PAC ID 4688057086, 16 clinicians

Uplift Health Technologies IncGroup PAC ID 5092109918, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Uplift Behavioral Health PC

  • Adult Mental Health Clinic/Center
  • Bethesda, MD
  • NPI 1629740410

  Clinical, DC

  Medicare reassignment Care Compare group NPD
• Uplift Health Technologies, Inc.

  • Adult Mental Health Clinic/Center
  • Arlington, VA
  • NPI 1770189243

  DC

  Medicare reassignment Care Compare group NPD
• Enhancing Your Walk LLC

  • Clinical Social Worker
  • Hughesville, MD
  • NPI 1326971672

  Clinical

  NPD Authorized official
• Safe Harbor Christian Counseling LLC

  • Clinical Social Worker
  • Bel Air, MD
  • NPI 1245377894

  Clinical

  NPD

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1487010971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7124 LANGLEY CT",
            "city": "HUGHESVILLE",
            "state": "MD",
            "postal_code": "206372714",
            "telephone_number": "240-577-5528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 FETCHER AVENUE",
            "city": "JOINT BASE ANDREWS",
            "state": "MD",
            "postal_code": "20762",
            "telephone_number": "240-612-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBOS",
        "first_name": "TRACY",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW-C, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC303237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 316TH Medgrp-Malcolm Grow
• Andrea Bonavente
• Alixandra Burks, PH.D.
• Andrew Talabon Chua, DMD
• Jeremy Gallman, DVM
• Chris Anthony Girouard II, D.D.S.

• All providers in Joint Base Andrews, MD
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; 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.