Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Charles C Tracy, LICSW

Individual provider Clinical Social Worker · NPI 1710076393

Charles C Tracy, LICSW is a Clinical Social Worker in Minneapolis, Minnesota. Licensed in Minnesota. Registered with an NPI since 2006.

Licensed in
MN
In the registry since
2006
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

717 E River Pkwy
Minneapolis, MN 55455-0369
Phone: (612) 436-4800
Fax: (612) 436-2606
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 01754 (MN)

Record details

NPI number1710076393
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedOctober 12, 2006
Last updated in NPPESJuly 8, 2007

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