Tamara L Luckett, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-11100 Issued in AZ

Practice address

1415 N 1St St
Phoenix, AZ 85004-1604

Phone

(602) 302-7815

Fax

(602) 258-6140

NPI assigned

Apr 7, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Tamara L Luckett-Callahan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207526400000",
    "number": "1154594588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122902",
            "telephone_number": "602-685-6000",
            "fax_number": "602-685-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 N 1ST ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041604",
            "telephone_number": "602-302-7815",
            "fax_number": "602-258-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKETT",
        "first_name": "TAMARA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-07",
        "last_updated": "2008-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-11100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMARA",
            "last_name": "LUCKETT-CALLAHAN",
            "middle_name": "L",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lucid Behavioral Health LLC
• Wendy Ann Lucid, MD
• Guylene Lucien
• Raul Lucio
• Jeffrey Luckett
• Lucky Pennies LLC
• Lucy Homes LLC
• Tony Ludden, PHARM D.
• Dale Allen Ludke, ORTHOTIC FITTER
• Ellen Ludwig, M.S. L.AC.

• Clinical Social Worker in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; 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.