Tracy George LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LC15680 Issued in ME

Legal business name

TRACY GEORGE LLC

Practice address

45 Pleasant Ave
Portland, ME 04103-3217

Phone

(603) 343-6352

Fax

(207) 221-1219

NPI assigned

Sep 2, 2016

Organization subpart

No

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

Authorized official

Name

Tracy E George, LCSWNPI 1720259047

Title

Ceo

Phone

(603) 343-6352

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy E George, LICSW

  • Clinical Social Worker
  • Rochester, NH
  • NPI 1720259047
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472774400000",
    "number": "1710434170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 TOPAZ PL",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038013583",
            "telephone_number": "603-343-6352",
            "fax_number": "207-221-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 PLEASANT AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033217",
            "telephone_number": "603-343-6352",
            "fax_number": "207-221-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY GEORGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-02",
        "last_updated": "2016-09-02",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "603-343-6352",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ME",
            "license": "LC15680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kassidy Elizabeth Towne, OT
• Brian Maynard Townsend, LCPC
• Jessica Townsend, LCSW
• Alicia Tozier, PA
• Michael Tozier, MD
• Tracy K Giles PA
• Alexandra Tracy
• Tradecraft12 Inc.
• Christian David Trahan, CRNA
• Wyatt John Traina, D.M.D.

• Community/Behavioral Health Agency in Portland, ME
• Providers in Portland, ME by specialty
• Community/Behavioral Health Agency in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.