Individual provider Active NPI

Marisa Tucker, L.C.S.W.

  • Mental Health Counselor
  • Florham Park, NJ
National Provider Identifier
1053346874
Registry record updated Jun 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
44SC05278800 Issued in NJ
Practice address
135 Columbia Turnpike Suite 303
Florham Park, NJ 07932
Phone
(973) 809-6446
NPI assigned
Jul 11, 2006
Last updated
Jun 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 44SC05278800 NJ Primary

Addresses

Primary practice location

135 Columbia Turnpike Suite 303
Florham Park, NJ 07932

Mailing address

35 Shadowlawn Dr
Livingston, NJ 07039-3144
Phone (973) 994-1752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20061130000382 NJ Practitioner - Clinical Social Worker 5294733192 Practice locations: West Orange, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

35 Shadowlawn Dr
Livingston, NJ 07039-3144

741 Northfield Ave
Suite 201
West Orange, NJ 07052-1104
Phone (973) 809-6446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05278800NJMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Psychiatry of North Jersey, LLC Mental Health PastSince Jul 1, 2002 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687651200000",
    "number": "1053346874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 SHADOWLAWN DR",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070393144",
            "telephone_number": "973-994-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 COLUMBIA TURNPIKE SUITE 303",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "07932",
            "telephone_number": "973-809-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MARISA",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-06-25",
        "certification_date": "2023-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SC05278800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florham Park, NJ

Sources for this page

Verify at the official NPI Registry.