Tracey B Carroll, LCSW
Individual provider Active NPI Social Worker · Lexington, KY
NPI 1639227010 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1639227010
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 1540 (KY)
- Practice address
- 3565 Tates Creek Rd
Apt 50
Lexington, KY 40517-2604 - Phone
- (859) 253-1686
- Fax
- (859) 254-2743
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 1540 | KY | Yes |
Addresses
Primary practice location
3565 Tates Creek Rd
Apt 50
Lexington, KY 40517-2604
Mailing address
1351 Newtown Pike
Lexington, KY 40511-1217
Phone (859) 253-1686
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30615058 | Medicaid | KY |
Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.