Active NPI
Tracey S Collins
- Social Worker
- Liberty, IN
National Provider Identifier
1619684776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.0008550
- Practice address
- 2345 W Old 101 Rd
Liberty, IN 47353-9392 - Phone
- (513) 720-3056
- NPI assigned
- Oct 28, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.0008550 | OH | Primary |
Addresses
Primary practice location
2345 W Old 101 Rd
Liberty, IN 47353-9392
Mailing address
2345 W Old 101 Rd
Liberty, IN 47353-9392
Phone (513) 720-3056
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
| License | State | Type | Specialty |
|---|---|---|---|
| S.0008550 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666915200000",
"number": "1619684776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2345 W OLD 101 RD",
"city": "LIBERTY",
"state": "IN",
"postal_code": "473539392",
"telephone_number": "513-720-3056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2345 W OLD 101 RD",
"city": "LIBERTY",
"state": "IN",
"postal_code": "473539392",
"telephone_number": "513-720-3056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "TRACEY",
"middle_name": "S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-28",
"last_updated": "2022-10-28",
"certification_date": "2022-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.0008550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liberty, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.