Active NPI
Tracy Elaine Brubaker, MSW, LICSW
- Clinical Social Worker
- Westborough, MA
National Provider Identifier
1851488597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 112140
- Practice address
- 69 Milk St
Suite 201
Westborough, MA 01581 - Phone
- (508) 340-1170
- NPI assigned
- Oct 6, 2006
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 112140 | MA | Primary |
Addresses
Primary practice location
69 Milk St
Suite 201
Westborough, MA 01581
Mailing address
69 Milk St.
Suite 201
Westborough, MA 01581
Phone (508) 340-1170
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
| License | State | Type | Specialty |
|---|---|---|---|
| 112140 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1851488597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "69 MILK ST.",
"address_2": "SUITE 201",
"city": "WESTBOROUGH",
"state": "MA",
"postal_code": "01581",
"telephone_number": "508-340-1170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "69 MILK ST",
"address_2": "SUITE 201",
"city": "WESTBOROUGH",
"state": "MA",
"postal_code": "01581",
"telephone_number": "508-340-1170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUBAKER",
"first_name": "TRACY",
"middle_name": "ELAINE",
"credential": "MSW, LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-06",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "112140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.