Tracy L. Ross-Fares, LCSW, C-ASWCM

Primary specialty

Social WorkerTaxonomy code 104100000X

License

SW 4952 Issued in FL

Practice address

2104 Massey Avenue
Naval Station, Mayport
Mayport, FL 32228

Phone

(904) 270-4294

Fax

(904) 270-4457

NPI assigned

Apr 10, 2006

Last updated

Apr 22, 2013By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1568425627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322145005",
            "telephone_number": "904-270-4294",
            "fax_number": "904-270-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 MASSEY AVENUE",
            "address_2": "NAVAL STATION, MAYPORT",
            "city": "MAYPORT",
            "state": "FL",
            "postal_code": "32228",
            "telephone_number": "904-270-4294",
            "fax_number": "904-270-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS-FARES",
        "first_name": "TRACY",
        "middle_name": "L.",
        "credential": "LCSW, C-ASWCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW 4952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Franklin Earl Hart, DDS
• Robert Lee King, IDC
• Christopher Charles Leclaire, D.D.S
• William Lopez Jr., DMD, MS, MPA
• NH Jacksonville
• Devon Schefano, IDC
• Dustin K Smith, D.O.
• Haley Emma Volante, IDC
• Wendy Ann Wasson, CPHT
• Thomas M. Williams, P.A.

• Social Worker in Mayport, FL
• Providers in Mayport, FL by specialty
• Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; 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.