Individual provider Active NPI

Tracy Marie Newbern, LMSW, LISW-S, LCSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1922208537
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801074329 Issued in MI
Practice address
2215 Fuller Rd
Ann Arbor, MI 48105-2303
Phone
(734) 644-7036
Fax
(734) 222-7916
NPI assigned
Jul 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.1600780-SUPV OH
Clinical Social Worker 1041C0700X 6801074329 MI Primary

Addresses

Primary practice location

2215 Fuller Rd
Ann Arbor, MI 48105-2303

Mailing address

PO Box 352024
Toledo, OH 43635-2024
Phone (615) 975-9068

Other practice location 1

2138 Loxley Rd
Toledo, OH 43613-5015
Phone (419) 902-2010

Other names 1

  • Dr. Tracy Marie Newbern Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20260311001035 MI Practitioner - Clinical Social Worker 0547743221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2920 Fuller Ave NE
Suite 208
Grand Rapids, MI 49505-3458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801074329MIMDClinical Social Worker
I.1600780-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bridge to Restoration Therapy Services Clinical CurrentSince Feb 6, 2026 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients

Locations

2920 Fuller Ave NE
Ste 208
Grand Rapids, MI 49505
Phone (616) 551-2916

Interoperability endpoints

  • Direct secure messaging: tracynewbern@tdh.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1184976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1922208537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 352024",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436352024",
            "telephone_number": "615-975-9068",
            "fax_number": "855-450-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 FULLER RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052303",
            "telephone_number": "734-644-7036",
            "fax_number": "734-222-7916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2138 Loxley Rd",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436135015",
            "country_code": "US",
            "telephone_number": "419-902-2010",
            "fax_number": "855-450-2036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWBERN",
        "first_name": "TRACY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "LMSW, LISW-S, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-21",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1600780-SUPV",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801074329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "NEWBERN",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.