TRACY A. CULLEN


Address: 31 Industrial Blvd, Medford, NY 11763-2220
Phone: 6319244411

TRACY A. CULLEN (NPI# 1265646087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265646087
Entity Type Individual
Full Name TRACY A. CULLEN
Other Name TRACY NORMAN
Credential LCSW
Practice Address 31 Industrial Blvd
Medford
NY 11763-2220
Mailing Address 208 Grant St
Massapequa Park
NY 11762-1520
Practice Telephone 6319244411
Mailing Telephone 5165575501
Enumeration Date 2007-05-10
Last Update Date 2010-03-31
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 104100000X Social Worker 074269-1 NY Behavioral Health & Social Service Providers
Y 1041C0700X Social Worker
Specialization: Clinical
077204-1 NY Behavioral Health & Social Service Providers

Office Location

Street Address 31 INDUSTRIAL BLVD
City MEDFORD
State NY
Zip Code 11763-2220

Providers in the same location

NPI Name Taxonomy Address Enumeration
1992326375 Kerry Anderson Social Worker 31 Industrial Blvd, Medford, NY 11763-2220 2020-04-27
1609316504 Darlene Lewis Social Worker 31 Industrial Blvd, Medford, NY 11763-2220 2017-02-27
1760922652 Michelle Muller Peer Specialist 31 Industrial Blvd, Medford, NY 11763-2220 2017-02-27
1962859488 Mcreynald Balthazar Registered Nurse 31 Industrial Blvd, Medford, NY 11763-2220 2016-05-16
1912369224 Gail Rudy-giannino Counselor 31 Industrial Blvd, Medford, NY 11763-2220 2016-03-25
1952763716 Kathleen Lao Counselor 31 Industrial Blvd, Medford, NY 11763-2220 2016-03-22
1790147411 The Yaphank Center Community/Behavioral Health 31 Industrial Blvd, Medford, NY 11763-2220 2016-03-22
1770945552 Marilyn Clarke Peer Specialist 31 Industrial Blvd, Medford, NY 11763-2220 2016-03-22
1447612171 Thomas Gaynor Rehabilitation Practitioner 31 Industrial Blvd, Medford, NY 11763-2220 2016-03-22
1265893507 Beth Ann Boss Peer Specialist 31 Industrial Blvd, Medford, NY 11763-2220 2016-03-15
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1316572027 Rebecca Molino Specialist 9, 3251 Ny-112 #2, Medford, NY 11763 2020-03-03
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1215419650 Megan Bell Speech-Language Pathologist 135 Buffalo Avenue, Medford, NY 11763 2018-09-01
1922592906 Elizabeth L Oakley Specialist 1 Sprat St, Medford, NY 11763 2018-06-21
1609383389 Federation of Organizations for The New York State Mentally Disabled Clinic/Center 3390 Route 112 Ste B, Medford, NY 11763 2018-01-04
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1134527054 Angelo L D'esposito Social Worker 77 Robinson Ave, Medford, NY 11763 2014-12-09
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Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified]

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1295218758 Julia Dennon Wise Social Worker 17 Wyman St, Medford, MA 02155-3401 2018-09-11
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Competitor

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City MEDFORD
Zip Code 11763

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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