Tracy Riley Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW9355 Issued in FL

Legal business name

TRACY RILEY COUNSELING LLC

Practice address

10151 Deerwood Park Blvd Ste 200-250
Jacksonville, FL 32256

Phone

(904) 704-2527

NPI assigned

Aug 9, 2013

Last updated

Aug 10, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tracy M Riley, LCSWNPI 1679762553

Title

Owner

Phone

(904) 704-2527

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Tracy Riley Counseling LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• New Hope, LLC

  • Clinical Social Worker
  • Macclenny, FL
  • NPI 1629377080
  NPD tax ID
• Tracy Riley Counseling LLC

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1306234950
  NPD tax ID

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tracy M Riley, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1679762553
  Medicare reassignment NPD Authorized official
• Greta Maria Abraham, MSW

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1932051505
  NPD (past)
• Stacey Denise Rowe, MA, RMHCI

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1962806752
  NPD (past)
• Lauren Timney, LMHC MS

  • Counseling Psychologist
  • Merritt Island, FL
  • NPI 1760880165
  NPD (past)
• Andre P Bouhasin, MD

  • Interventional Cardiology Physician
  • Farmington, MO
  • NPI 1508808635
  NPD (past)

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533859200000",
    "number": "1902239270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10151 DEERWOOD PARK BLVD STE 200-250",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560589",
            "telephone_number": "904-704-2527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10151 DEERWOOD PARK BLVD STE 200-250",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-704-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY RILEY COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-09",
        "last_updated": "2018-08-10",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-704-2527",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 5716",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9355",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "FL",
            "license": "ME0045122",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008697300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Ronald Trace, PT
• Taylor Gregory Trace, PA-C
• Tracey Oneill Inc (Live Well With Food)
• Jonathan David Tracey, PHARM.D.
• Tracy Riley Counseling LLC
• Michael C Tracy, MD
• Susanne Tracy, M.D.
• Vanessa Tracz
• Trading-Interventions
• Traditional Home Care, Inc. (Medical Services of America Home Health)

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.