Individual provider Active NPI

Wendy Lucker, L.C.S.W.

  • Clinical Social Worker
  • St Petersburg, FL
National Provider Identifier
1144416173
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW16402 Issued in FL
Practice address
537 42ND Ave N
St Petersburg, FL 33703-5720
Phone
(541) 350-7041
NPI assigned
Sep 24, 2007
Last updated
Nov 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L3492 OR
Clinical Social Worker 1041C0700X CSW004455 GA
Clinical Social Worker 1041C0700X SW16402 FL Primary

Addresses

Primary practice location

537 42ND Ave N
St Petersburg, FL 33703-5720

Mailing address

537 42ND Ave N
St Petersburg, FL 33703-5720
Phone (541) 350-7041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3492ORMDClinical Psychologist
SW16402FLMDClinical Social Worker
CSW004455GAMDClinical Social Worker
L3492ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wendy Lucker LLC Clinical Current 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": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1144416173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 42ND AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337035720",
            "telephone_number": "541-350-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 42ND AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337035720",
            "telephone_number": "541-350-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKER",
        "first_name": "WENDY",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-24",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3492",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004455",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.