Tracy D'Andrea Charles, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C009820 Issued in NC

Practice address

3000 Bethesda PL Ste 201
Winston Salem, NC 27103-3324

Phone

(336) 793-5718

Fax

(336) 790-6770

NPI assigned

Nov 28, 2014

Last updated

Jul 2, 2021By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Forever Hope, PLLC

  • Clinical Social Worker
  • Winston Salem, NC
  • NPI 1013507862
  Authorized official Same address or phone

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

{
    "created_epoch": "1417132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1790182251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 BETHESDA PL STE 201",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033324",
            "telephone_number": "336-793-5718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 BETHESDA PL STE 201",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033324",
            "telephone_number": "336-793-5718",
            "fax_number": "336-790-6770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520A Arbor Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Kernersville",
            "state": "NC",
            "postal_code": "27284",
            "country_code": "US",
            "telephone_number": "336-283-3830 x10",
            "fax_number": "336-283-3827",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "234C E Washington St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274012704",
            "country_code": "US",
            "telephone_number": "336-420-1885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "TRACY",
        "middle_name": "D'ANDREA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-28",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Chaput, PT
• Charles G New DDS Ms PA
• Charles Hines & Son, Inc
• Charles Hines & Son, Inc
• Ronald Allen Charles, M.D.
• Charlotte Broughton, DDS
• Charlotte Eye Ear Nose & Throat Associates, P.a.
• Brianna Rebecca Charpie, PA-C
• Kelly Chase, MA, CCC-SLP
• Adrienne Chasten

• Clinical Social Worker in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; 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.