Tracey Lee Minervino, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC13255 Issued in ME

Practice address

141 N Main St Ste 203
Brewer, ME 04412-2055

Phone

(207) 907-4343

Fax

(207) 907-4343

NPI assigned

Jun 24, 2008

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 ME

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

SweetserGroup PAC ID 8325946213, 138 clinicians

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.

• Sweetser

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saco, ME
  • NPI 1538122445
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1912168790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N MAIN ST STE 203",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044122055",
            "telephone_number": "207-907-4343",
            "fax_number": "207-907-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N MAIN ST STE 203",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044122055",
            "telephone_number": "207-907-4343",
            "fax_number": "207-907-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINERVINO",
        "first_name": "TRACEY",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC13255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott J. Melton, MD PH.D.
• Maggie Menter
• Angel K Merchant, FNP
• Sarah Marie Mierz, PHARMD
• Jeffrey Michael Millett, FNP
• Courtney P Mishou, LMSW-CC
• Jennifer Mitchell, OT
• Sarah Mitchell, PT, DPT
• Eileen G Moore, LSW
• Sarah Grace Moore, MS OTR/L

• Clinical Social Worker in Brewer, ME
• Providers in Brewer, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.