Olivia Kathleen Tucker, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801103784 Issued in MI

Practice address

10801 S Saginaw St Ste D
Grand Blanc, MI 48439-8126

Phone

(810) 771-4074

Fax

(810) 866-4450

NPI assigned

Mar 23, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Creekside Counseling Group LLCGroup PAC ID 9133521255, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Creekside Counseling Group LLC

  • Clinical Social Worker
  • Grand Blanc, MI
  • NPI 1619550860
  Medicare reassignment Care Compare group NPD
• Catholic Charities of Shiawassee and Genesee Counties

  • Mental Health Counselor
  • Owosso, MI
  • NPI 1689155590
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1003278631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 MARTHA CT",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484467605",
            "telephone_number": "810-441-6477",
            "fax_number": "810-232-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 S SAGINAW ST STE D",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398126",
            "telephone_number": "810-771-4074",
            "fax_number": "810-866-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "OLIVIA",
        "middle_name": "KATHLEEN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801103784",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801103784",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Khanh Truong, MD
• Mai Phuong Truong, MD
• Trusted Home Care Services, LLC
• Lisa Tryee - Lacy
• Alona Tucker
• Shelia Evette Tucker, MSW
• Alekya Tummala, MD, MS
• Jessie Turk
• Alissa Turnbull, DO
• Turner Therapy LLC

• Clinical Social Worker in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.