MEDICARE: TRACEY ANN THOMPSON BARNES LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	121679	NY

General Provider Information

NPI Number	:	1851164172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACEY ANN THOMPSON BARNES LMSW

Provider Business Mailing Address
First Line	:	16842 127TH AVE APT 2A
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11434-3125
Country	:	US
Telephone Number	:	347-896-4350
Fax Number	:

Provider Business Practice Location Address
First Line	:	2932 WILKINSON AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-4004
Country	:	US
Telephone Number	:	347-544-0955
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2023
Last Update Date	:	10/31/2023

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