Tracy L Williams, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2002224 Issued in OH

Practice address

975 Kingsview Dr
BLDG a
Lebanon, OH 45036-9562

Phone

(513) 228-7800

Fax

(513) 228-7846

NPI assigned

Oct 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5507/brand/1/csg/1/fhir/r4
• FHIR API: https://api.qualifacts.org/api/fhir/mpwhealth/r4/

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.

• Modern Psychiatry and Wellness LLC

  • Adult Mental Health Clinic/Center
  • Hamilton, OH
  • NPI 1225260888
  Medicare reassignment NPD
• Modern Psychiatry & Wellness, LLC

  • Adult Mental Health Clinic/Center
  • Hamilton, OH
  • NPI 1699251553
  NPD
• Emerge Recovery and Trades Initiative

  • Community/Behavioral Health Agency
  • Xenia, OH
  • NPI 1205544426
  NPD (past)

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1508318239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 COLUMBUS AVE",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450361754",
            "telephone_number": "513-520-7888",
            "fax_number": "513-932-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 KINGSVIEW DR",
            "address_2": "BLDG A",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450369562",
            "telephone_number": "513-228-7800",
            "fax_number": "513-228-7846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "759 Columbus Ave",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OH",
            "postal_code": "450361754",
            "country_code": "US",
            "telephone_number": "513-520-7888",
            "fax_number": "513-932-6750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TRACY",
        "middle_name": "L",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-28",
        "last_updated": "2022-03-01",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2002224",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S-1600992",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0289271",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Wientge
• Victoria Wilburn, NP
• Joshua J Wilcox
• Sarah Ann Wilkus, RRT
• Erin Williams, RN
• Kathy A Williamson, PTA
• Michelle Nicole Williamson, LSW
• McKenzie Wills, CF-SLP
• Sonja M Wills, NP-C
• Jamie Wilson

• Clinical Social Worker in Lebanon, OH
• Providers in Lebanon, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.