Tracy L Pequignot, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW015745 Issued in PA

Practice address

7095 Route 287
Wellsboro, PA 16901

Phone

(570) 724-5272

Fax

(570) 724-4512

NPI assigned

Mar 20, 2008

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

Enrolled in PA

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

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Harbor Counseling

  • Addiction (Substance Use Disorder) Counselor
  • Wellsboro, PA
  • NPI 1699754424
  Medicare reassignment NPD

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1639340300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7095 ROUTE 287",
            "address_2": "PO BOX 685",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169016711",
            "telephone_number": "570-724-5272",
            "fax_number": "570-724-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7095 ROUTE 287",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "16901",
            "telephone_number": "570-724-5272",
            "fax_number": "570-724-4512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 Main St Unit 3",
            "address_purpose": "LOCATION",
            "city": "Wellsboro",
            "state": "PA",
            "postal_code": "169011518",
            "country_code": "US",
            "telephone_number": "570-723-1005",
            "fax_number": "570-723-1006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "PO Box 685",
            "address_purpose": "LOCATION",
            "city": "Wellsboro",
            "state": "PA",
            "postal_code": "169010685",
            "country_code": "US",
            "telephone_number": "570-724-5272 x227",
            "fax_number": "570-724-4512",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 Main St Ste 5",
            "address_purpose": "LOCATION",
            "city": "Blossburg",
            "state": "PA",
            "postal_code": "169121172",
            "country_code": "US",
            "telephone_number": "570-724-5272 x227",
            "fax_number": "570-724-4512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEQUIGNOT",
        "first_name": "TRACY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• David A. Pfisterer, M.D.
• Sherry D Pierce, DPT
• Kevin L Pigos, M.D.

• Clinical Social Worker in Wellsboro, PA
• Providers in Wellsboro, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.