Individual provider Active NPI

Tracy A Reid-Barrow, LCSW

  • Clinical Social Worker
  • Grovetown, GA
National Provider Identifier
1780950881
Registry record updated Oct 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005615 Issued in GA
Practice address
730 Porter LN
Grovetown, GA 30813-2288
Phone
(347) 834-1513
Fax
(706) 925-5692
NPI assigned
Mar 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0777851 NY
Clinical Social Worker 1041C0700X 73 080758 NY
Clinical Social Worker 1041C0700X CSW005615 GA Primary

Addresses

Primary practice location

730 Porter LN
Grovetown, GA 30813-2288

Mailing address

730 Porter LN
Grovetown, GA 30813-2288
Phone (347) 834-1513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW005615GAMDClinical Social Worker
0777851NYMDClinical Social Worker
73 080758NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1780950881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 PORTER LN",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308132288",
            "telephone_number": "347-834-1513",
            "fax_number": "706-925-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 PORTER LN",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308132288",
            "telephone_number": "347-834-1513",
            "fax_number": "706-925-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID-BARROW",
        "first_name": "TRACY",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0777851",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73 080758",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grovetown, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.