Tracy Ann Hogan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW5377 Issued in FL

Practice address

12017 SW Bennington Cir
Port St Lucie, FL 34987-2723

Phone

(772) 345-2223

NPI assigned

May 21, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tracy Ann Amon Former name

Medicare fee-for-service enrollment

Enrolled in FL

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, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Change of Mind LLCGroup PAC ID 4284971672, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Change of Mind LLC

  • Mental Health Counselor
  • Port St Lucie, FL
  • NPI 1811443195
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1730746108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12017 SW BENNINGTON CIR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872723",
            "telephone_number": "772-345-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12017 SW BENNINGTON CIR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872723",
            "telephone_number": "772-345-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "AMON",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Larry L Hilton, CRNA
• John T Himebaugh, CRNA
• Hoatc Pharmacy, LLC
• Hofstee Chiropractic & Wellness Clinic LLC
• Angela Hogan
• Daniel Cade Hohler, DO
• Meghan Holak
• Holiday CVS LLC (CVS Pharmacy #07923)
• Holiday CVS LLC (CVS Pharmacy #17323)
• Joy Dianne Hollabaugh, MS CCC-SLP

• Clinical Social Worker in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; 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.