Tracy Lynn Cunningham, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149015967 Issued in IL

Practice address

684 W Boughton Rd Ste 106
Bolingbrook, IL 60440-1781

Phone

(630) 410-9578

Fax

(630) 296-0749

NPI assigned

Nov 17, 2019

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, AZ2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fash Counseling IncGroup PAC ID 4183003056, 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 and National Provider Directory roles.

• Fash Counseling Inc.

  • Mental Health Counselor
  • Bolingbrook, IL
  • NPI 1346766250

  AZ

  Medicare reassignment Care Compare group NPD
• Pivotal Health and Wellness LLC

  • Chiropractor
  • Bolingbrook, IL
  • NPI 1679290845
  NPD

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

{
    "created_epoch": "1573948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573948800000",
    "number": "1508401209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "684 W BOUGHTON RD STE 106",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401781",
            "telephone_number": "630-410-9578",
            "fax_number": "630-296-0749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 W BOUGHTON RD STE 106",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401781",
            "telephone_number": "630-410-9578",
            "fax_number": "630-296-0749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-17",
        "last_updated": "2019-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL SOCIAL WORK",
            "identifier": "350601850",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "fashcounseling.com",
            "affiliation": "N",
            "address_1": "684 W Boughton Rd Ste 106",
            "city": "Bolingbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604401781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marilyn Cavite Cruz-Rosal, PT,DPT
• Katrina Cudal
• Jennifer Lynn Cunningham
• Jessica Nicole Cunningham, MD, MPH
• Michelle Lee Cunningham, LCSW
• Giovanni Curcio, M.D.
• Rachael Terese Cutts, MA, LCPC, CADC
• D&D Home Health Incorporated
• Daily Nutrition LLC
• Heidi Silke Daley, PT

• Clinical Social Worker in Bolingbrook, IL
• Providers in Bolingbrook, 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 Nov 17, 2019; 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.