TRACY GORDON (LICSW) – Clinical Social Worker, NPI 1649430695

TRACY GORDON (LICSW) is a healthcare provider. based in Saint cloud, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 19077 (MN). The NPI Number for TRACY GORDON (LICSW) is 1649430695

Main info

Female
Sole Proprietor
18 Years Of Experience
Accepts Medicare Assignment
Name
TRACY GORDON (LICSW)
NPI
1649430695
Phone
(320) 252-1670
Address
4801 VETERANS DR
Enumeration Date
12 June 2008
Last Update Date
29 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3202522976
Graduation Year
2008 (18 years ago)
PAC ID
0840715421
Group Practice PAC ID
2860447604
Professional Enrollment ID
I20250416000812
Address ID
MN563871314WA110XXSTXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:17State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

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Provider Addresses for TRACY GORDON (LICSW)

  • St. Cloud VA Health Care System, 4801, Veterans Drive, St. Cloud, Stearns County, Minnesota, 56303, United States

    SAINT CLOUD, MN 563032015

    Phone: (320) 252-1670

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-04-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250416000812IClinical Social WorkerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 56303)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860447604View full group profile
NameSpecialtyState
Clinical Social WorkerMN
P S Y C H I A T R YMN
Clinical PsychologistMN
Clinical Social WorkerIA
Marriage And Family TherapistMN
Mental Health CounselorND
Marriage And Family TherapistMN
-MN
Clinical Social WorkerMN
-MN

Reviews

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Frequently asked questions

Does TRACY GORDON (LICSW) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — TRACY GORDON (LICSW) uses 1649430695.
Does CMS list TRACY GORDON (LICSW) as active?
Yes — TRACY GORDON (LICSW) is active in the NPI listing used on this page.
What is TRACY GORDON (LICSW) best known for clinically?
Directory data describes TRACY GORDON (LICSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Does TRACY GORDON (LICSW) list a practice location?
Patients near Saint Cloud, Minnesota may find TRACY GORDON (LICSW) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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