MRS. TRACEY DIANE NIECKARZ (NPI# 1336610120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336610120 |
| Entity Type | Individual |
| Full Name | MRS. TRACEY DIANE NIECKARZ |
| Credential | LCSW-R |
| Practice Address |
300 Wood Rd Ballston Spa NY 12020-2246 |
| Mailing Address |
70 Malta Ave Ballston Spa NY 12020-1529 |
| Practice Telephone | 5188847290 |
| Practice Fax Number | 5188847286 |
| Mailing Telephone | 5188847195 |
| Mailing Fax Number | 5188847101 |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2018-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
R055638 | NY | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 300 Wood Rd, Ballston Spa, NY 120202246 | 5188847290 | 5188847286 |
| Street Address |
300 WOOD RD |
| City | BALLSTON SPA |
| State | NY |
| Zip Code | 12020-2246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013225598 | Janice D Mcphee | Registered Nurse | 300 Wood Rd, Ballston Spa, NY 12020-2246 | 2010-09-18 |
| 1821533563 | Benjamin Thomas Scharett | Social Worker | 300 Wood Rd, Ballston Spa, NY 12020-2246 | 2017-01-04 |
| 1043619877 | Patricia Bentley | Registered Nurse | 300 Wood Rd, Ballston Spa, NY 12020-2246 | 2014-08-18 |
| 1225467434 | Nancy Cicciu | Registered Nurse | 300 Wood Rd, Ballston Spa, NY 12020-2246 | 2013-11-07 |
| 1952608523 | Callie M Savoie | Licensed Practical Nurse | 300 Wood Rd, Ballston Spa, NY 12020-2246 | 2011-02-17 |
| 1972807758 | Kathleen Mary Jacko | Speech-Language Pathologist | 300 Wood Rd, Ballston Spa, NY 12020-2246 | 2011-01-07 |
| 1760790190 | Laura Britto Shockley | Social Worker | 300 Wood Rd, Ballston Spa, NY 12020-2246 | 2010-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811529415 | Peter Joseph Valastro Jr. | Registered Nurse | 2452 Us Rt 9 Suite 206, Malta, NY 12020 | 2020-02-11 |
| 1083257224 | Martins Foods of South Burlington LLC | Durable Medical Equipment & Medical Supplies | 3 Via Rossi Way, Ballston Spa, NY 12020 | 2019-10-21 |
| 1528542255 | Mary Szacik | Social Worker | 2452 Us Rt. 9, Suite 206, Malta, NY 12020 | 2018-09-19 |
| 1669966867 | Adam Smatko | Social Worker | 2452 Us Route 9, Suite 206, Malta, NY 12020 | 2018-06-20 |
| 1538665104 | Tressa Frese | Counselor | 35 Bath Street, Ballston Spa, NY 12020 | 2018-04-03 |
| 1902312556 | Maltavista Optometry, Pllc | Optometrist | 2715 Rt 9, Suite 204, Malta, NY 12020 | 2017-12-19 |
| 1497207294 | Julie Lapham | Counselor | 100 Saratoga Village Blvd. Suite 26, Malta, NY 12020 | 2016-10-27 |
| 1932656527 | Matthew Kattell | Physical Therapist | 4102 Ellsworth Boulevard, Malta, NY 12020 | 2016-09-01 |
| 1295134740 | Nnenna Lindsay | Psychologist | 15 Trieble Avenue, Suite 5 Pmb 1013, Ballston Spa, NY 12020 | 2014-08-21 |
| 1023425956 | Jessica Duell | Registered Nurse | 603 Sweetman Road, Ballston Spa, NY 12020 | 2014-07-11 |
| Find all providers in zip 12020 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083058614 | John Joseph Mullaney | Social Worker | 174 Milton Ave, Apartment 2, Ballston Spa, NY 12020-1452 | 2013-04-25 |
| 1164723144 | Lavonne Freeman | Social Worker | 2452 State Route 9 Ste 302, Ballston Spa, NY 12020-4449 | 2010-11-08 |
| 1447568621 | Victoria Betesh | Social Worker | 5 Hemphill Pl, Ballston Spa, NY 12020-4422 | 2010-09-21 |
| 1891949798 | Maureen J Forsyth | Social Worker | 27 Mann Rd, Ballston Spa, NY 12020-3519 | 2008-11-05 |
| 1124107859 | Darlene C Stiffler | Social Worker | 419 Geyser Rd, Ballston Spa, NY 12020-3022 | 2006-11-03 |
| 1861478919 | Patricia A Huber Villano | Social Worker | 15 Trieble Ave Ste 5, Ballston Spa, NY 12020-6027 | 2005-12-21 |
| 1760786636 | Christina Campagna Rees | Social Worker | 433 Geyser Rd, Suite A, Ballston Spa, NY 12020-3022 | 2011-01-06 |
| 1760790190 | Laura Britto Shockley | Social Worker | 300 Wood Rd, Ballston Spa, NY 12020-2246 | 2010-09-20 |
| 1841402393 | Kathleen Fraser Moran | Social Worker | 419 Geyser Rd, Ballston Spa, NY 12020-3022 | 2007-05-05 |
| 1134147341 | Jeanette Carney | Social Worker | 20 Prospect St, Building 1, Suite 103, Ballston Spa, NY 12020-1367 | 2006-07-17 |
| Find all providers in BALLSTON SPA | ||||
| City | BALLSTON SPA |
| Zip Code | 12020 |
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| 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.