Tracy E Haller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC12776 Issued in ME

Practice address

741 Warren Ave
Portland, ME 04103-1007

Phone

(207) 879-6165

Fax

(207) 879-7466

NPI assigned

Apr 14, 2011

Last updated

Apr 14, 2011By the provider in NPPES

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

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Casa, Inc.

  • Adult Care Home Facility
  • Portland, ME
  • NPI 1902090285
  Medicare reassignment

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1952691677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040980150",
            "telephone_number": "207-879-6165",
            "fax_number": "207-879-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 WARREN AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031007",
            "telephone_number": "207-879-6165",
            "fax_number": "207-879-7466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLER",
        "first_name": "TRACY",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-14",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC12776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Willow Hall, RN
• Teyonda Hall
• Brian L Halla, PA-C
• Lee D Hallagan, MD
• Sarah A. M. Hallen, M.D.
• Carlene Halligan, M.S. CCC-SLP
• Robert Joseph Hallinan, MD
• Anne Hallward, MD
• Halo Homecare LLC
• Jeffrey M. Halter, MD

• Clinical Social Worker in Portland, ME
• Providers in Portland, 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 Apr 14, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.