Active NPI
Jeanette Nicole Tucker, LCSW
- Clinical Social Worker
- Baltimore, MD
National Provider Identifier
1164978292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-4582
- Practice address
- 421 Fallsway
Baltimore, MD 21202-4800 - Phone
- (410) 837-5533
- NPI assigned
- Aug 29, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 21873 | MD | |
| Clinical Social Worker | 1041C0700X | LCSW-4582 | HI | Primary |
Addresses
Primary practice location
421 Fallsway
Baltimore, MD 21202-4800
Mailing address
Brian D. Allgood Community Hospital
Opc 371, Box 39
Apo, AP 96271-9001
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-4582 | HI | MD | Clinical Social Worker |
| 21873 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742342400000",
"number": "1164978292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "BRIAN D. ALLGOOD COMMUNITY HOSPITAL",
"address_2": "OPC 371, BOX 39",
"city": "APO",
"state": "AP",
"postal_code": "962719001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 FALLSWAY",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212024800",
"telephone_number": "410-837-5533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "JEANETTE",
"middle_name": "NICOLE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-29",
"last_updated": "2025-03-19",
"certification_date": "2025-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "21873",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "HI",
"license": "LCSW-4582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.