Individual provider Active NPI

Tracy-Jane E. Pierre, MSW, LICSW

  • Clinical Social Worker
  • Malden, MA
National Provider Identifier
1619643020
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
127922 Issued in MA
Practice address
105 Commercial St
Malden, MA 02148-5509
Phone
(781) 322-5101
NPI assigned
Aug 17, 2021
Last updated
Sep 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 127922 MA Primary

Addresses

Primary practice location

105 Commercial St
Malden, MA 02148-5509

Mailing address

PO Box 114
Malden, MA 02148-0011

Other practice location 1

30 Warren St
Brighton, MA 02135-3680
Phone (617) 254-3800

Other practice location 2

1 Boston Medical Ctr Pl
Boston, MA 02118-2908
Phone (617) 638-8000 ext. 6395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20251107003619 MA Practitioner - Clinical Social Worker 4385134238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Boston University School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

169 Madison Ave
New York, NY 10016-5101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
127922MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Third Space Therapy PLLC CurrentSince Jul 27, 2025 Accepting new patients
New York State Health Medical PC Past Accepting new patients
Pediatric Associates of Malden, PC PastSince Aug 10, 2025 Accepting new patients
Pediatric Associates of Malden PC PastSince Aug 10, 2025 Accepting new patients

Locations

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

169 Madison Ave
Ste 11299
New York, NY 10016
Phone (833) 244-4878

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1619643020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 114",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021480011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 COMMERCIAL ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485509",
            "telephone_number": "781-322-5101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Warren St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021353680",
            "country_code": "US",
            "telephone_number": "617-254-3800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Boston Medical Ctr Pl",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182908",
            "country_code": "US",
            "telephone_number": "617-638-8000 x6395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIERRE",
        "first_name": "TRACY-JANE",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "127922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

Verify at the official NPI Registry.