Tracy Penn, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15990 Issued in MN

Practice address

407 Washington St
Monticello, MN 55362-8815

Phone

(763) 888-9626

Fax

(763) 295-5086

NPI assigned

May 19, 2025

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 MN

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, 2002

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Central Minnesota Mental Health Center

  • Mental Health Counselor
  • Saint Cloud, MN
  • NPI 1831177195
  Medicare reassignment NPD
• Central Minnesota Mental Health Center

  • Counselor
  • Saint Cloud, MN
  • NPI 1053576546
  NPD

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

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1861284713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 WASHINGTON ST",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628815",
            "telephone_number": "763-888-9626",
            "fax_number": "763-295-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 WASHINGTON ST",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628815",
            "telephone_number": "763-888-9626",
            "fax_number": "763-295-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "TRACY",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-19",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrienne Marie Pacheco
• Jane Parker, N.P.
• Alpit D Patel, MBBS
• Adrienne Amanda Paulson, PHD
• Paws Up Animal Chiropractic LLC (Living Motion Chiropractic)
• Kristy Peterfeso, APRN, CNP
• Elizabeth Mae Peterka
• Jamie-Sue Peterson, MSW, LICSW
• Sara Christine Peterson
• Mikayla Pieper

• Clinical Social Worker in Monticello, MN
• Providers in Monticello, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.