Individual provider Active NPI

Tracy Erin Perry, LMSW

  • Mental Health Counselor
  • Painted Post, NY
National Provider Identifier
1528567757
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3805 Meads Creek Rd
Painted Post, NY 14870-9509
Phone
(607) 962-3100
Fax
(607) 962-4300
NPI assigned
Feb 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 107460-01 NY
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

3805 Meads Creek Rd
Painted Post, NY 14870-9509

Mailing address

963 Walnut St
Elmira, NY 14901-1831
Phone (607) 734-1447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107460-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Social Work and Counseling Services of the Finger Lakes Clinical CurrentSince Jan 17, 2022 Accepting new patients
Carefirst Ny, Inc. Past Accepting new patients

Locations

963 Walnut St
Elmira, NY 14901
Phone (607) 734-1447

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1528567757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "963 WALNUT ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149011831",
            "telephone_number": "607-734-1447",
            "fax_number": "607-767-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 MEADS CREEK RD",
            "city": "PAINTED POST",
            "state": "NY",
            "postal_code": "148709509",
            "telephone_number": "607-962-3100",
            "fax_number": "607-962-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "TRACY",
        "middle_name": "ERIN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-02",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "107460-01",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Painted Post, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.