Tracie Lynn Preli-Derwin

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

00734 Issued in CT

Practice address

96 Connecticut Blvd
East Hartford, CT 06108-3013

Phone

(860) 502-4908

Fax

(860) 513-4828

NPI assigned

May 14, 2012

Sex

Female

Sole proprietor

No

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 CT

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, 2007

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

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 and National Provider Directory roles.

• Tracie Preli-Derwin, LCSW, PLLC

  • Clinical Social Worker
  • Southington, CT
  • NPI 1124608054
  Medicare reassignment NPD Authorized official
• Staltaro Psychological Services LLC

  • Clinical Psychologist
  • Rocky Hill, CT
  • NPI 1841522216
  Medicare reassignment NPD
• Step Up Care PC LLC

  • Counselor
  • Danielson, CT
  • NPI 1154884740
  Medicare reassignment NPD
• Sunrise Psychological Services LLC

  • Psychologist
  • Prospect, CT
  • NPI 1699199869
  Medicare reassignment NPD

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501027200000",
    "number": "1497014344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 CONNECTICUT BLVD",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083013",
            "telephone_number": "860-502-4908",
            "fax_number": "860-513-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 CONNECTICUT BLVD",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083013",
            "telephone_number": "860-502-4908",
            "fax_number": "860-513-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRELI-DERWIN",
        "first_name": "TRACIE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-14",
        "last_updated": "2017-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "00734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Powell
• Power of You Therapy, LLC
• Nyasia Prado
• Jeffrey L Prebluda, M.D.
• Precision Optical Co.
• Pamela Kay Prescott
• Thomas J Prignano, O.D.
• Primary Prevention Home Care LLC
• Primary Prevention Homemakers and Companions LLC
• Jill M. Primerano, P.T.

• Clinical Social Worker in East Hartford, CT
• Providers in East Hartford, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.

Verify at the official NPI Registry.