TRACEY TILLINGHAST (LICSW) – Counselor, NPI 1093034381

TRACEY TILLINGHAST (LICSW) is a healthcare provider. based in Warwick, Rhode Island. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. ISW02714 (RI). The NPI Number for TRACEY TILLINGHAST (LICSW) is 1093034381

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
TRACEY TILLINGHAST (LICSW)
NPI
1093034381
Phone
(401) 785-0040
Address
300 TOLL GATE RD
Enumeration Date
26 May 2010
Last Update Date
17 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4014670333
Graduation Year
2010 (16 years ago)
PAC ID
2365746815
Group Practice PAC ID
5294173464
Professional Enrollment ID
I20160204000273
Address ID
RI028864416WA300XXRDXX403
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:16State licenses:1Digital endpointsOther names

712 CLINICAL SOCIAL WORKER in RI

Provider Addresses for TRACEY TILLINGHAST (LICSW)

  • 300 TOLL GATE RD

    WARWICK, RI 028864416

    Phone: (401) 785-0040

    Type: Mailing

  • 1516 ATWOOD AVE

    JOHNSTON, RI 029193223

    Phone: (401) 724-8400

    Fax: (401) 722-5039

    Type: Mailing

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: 2016-02-04

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
I20160204000273IClinical Social WorkerRITBD

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 02886)

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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: 5294173464View full group profile
NameSpecialtyState
Nurse PractitionerRI
Clinical PsychologistRI
Clinical Social WorkerAZ
Mental Health CounselorSD
Clinical Social WorkerRI
Mental Health CounselorRI
Clinical Social WorkerRI
Clinical Social WorkerRI
Clinical Social WorkerRI
Mental Health CounselorRI

Reviews

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Frequently asked questions

Can I use this page to confirm TRACEY TILLINGHAST (LICSW)'s NPI?
Yes. TRACEY TILLINGHAST (LICSW) is listed with NPI 1093034381 in the public NPI dataset.
Is TRACEY TILLINGHAST (LICSW) listed as active for patients and plans?
The listing shows TRACEY TILLINGHAST (LICSW) as active in the NPI system.
What is TRACEY TILLINGHAST (LICSW)'s primary classification?
Counselor is the headline specialty for TRACEY TILLINGHAST (LICSW) here. Clinical services aligned with this taxonomy classification.
Where should I expect TRACEY TILLINGHAST (LICSW) on a map?
Expect Warwick, Rhode Island as a primary anchor for TRACEY TILLINGHAST (LICSW) unless the record lists multiple sites.
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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