Active NPI
Tracy Elizabeth Adams, LCSW
- Clinical Social Worker
- Colorado Springs, CO
National Provider Identifier
1629536909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 84673
- Practice address
- 6020 Erin Park Dr Ste C
Colorado Springs, CO 80918-3429 - Phone
- (719) 203-9670
- NPI assigned
- Mar 6, 2019
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 84673 | CA | Primary |
Addresses
Primary practice location
6020 Erin Park Dr Ste C
Colorado Springs, CO 80918-3429
Mailing address
302 Iris Ave
Corona del Mar, CA 92625-2909
Phone (925) 330-4508
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09928191 | Other | CO | LICENSE NUMBER |
| 84673 | Other | CA | LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84673 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652227200000",
"number": "1629536909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 IRIS AVE",
"city": "CORONA DEL MAR",
"state": "CA",
"postal_code": "926252909",
"telephone_number": "925-330-4508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6020 ERIN PARK DR STE C",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809183429",
"telephone_number": "719-203-9670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMS",
"first_name": "TRACY",
"middle_name": "ELIZABETH",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-06",
"last_updated": "2022-05-11",
"certification_date": "2022-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "84673",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "09928191",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "84673",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.