Tracey Thompson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05482900 Issued in NJ

Practice address

100 Enterprise Dr Ste 301
Rockaway, NJ 07866-2129

Phone

(908) 242-6283

NPI assigned

May 31, 2020

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

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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.

• Tracey Telehealth Therapy LLC

  • Community/Behavioral Health Agency
  • Flanders, NJ
  • NPI 1386260099

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1590883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1750905352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ENTERPRISE DR STE 301",
            "city": "ROCKAWAY",
            "state": "NJ",
            "postal_code": "078662129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ENTERPRISE DR STE 301",
            "city": "ROCKAWAY",
            "state": "NJ",
            "postal_code": "078662129",
            "telephone_number": "908-242-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "TRACEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-31",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05482900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Center for Therapeutic Bodywork, LLC.
• The Eating Disorder Space, LLC
• Elsy Thomas, PHARMACIST
• Michelle Thomas, PHARMD
• Miriam Thomas, M.D.
• Hiteshkumar Timbadiya
• Michal Sarah Tingson, RN
• John Paul Tinio
• Tiny Triumphs LLC
• Sean Tippner, MA, LPC

• Clinical Social Worker in Rockaway, NJ
• Providers in Rockaway, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.