Tucker Wallace

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

249 E Tabernacle St Ste 100
St George, UT 84770-2951

Phone

(435) 705-7574

NPI assigned

Apr 18, 2019

Last updated

Jan 21, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cedar View Counseling LLC

  • Clinical Social Worker
  • Cedar City, UT
  • NPI 1811708829
  NPD Authorized official
• Utah Autism Academy

  • Developmentally Disabled Services Day Training Agency
  • Midvale, UT
  • NPI 1972934537
  NPD (past)

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1205499811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 S MAIN ST STE C7",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847203442",
            "telephone_number": "435-233-6981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 E TABERNACLE ST STE 100",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847702951",
            "telephone_number": "435-705-7574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1875 S Geneva Rd",
            "address_purpose": "LOCATION",
            "city": "Orem",
            "state": "UT",
            "postal_code": "840582217",
            "country_code": "US",
            "telephone_number": "801-437-0490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "444 S Main St Ste C7",
            "address_purpose": "LOCATION",
            "city": "Cedar City",
            "state": "UT",
            "postal_code": "84720",
            "country_code": "US",
            "telephone_number": "435-233-6981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "TUCKER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-18",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://crimsoncounseling.net",
            "affiliation": "N",
            "address_1": "249 E Tabernacle St Ste 100",
            "city": "St George",
            "state": "UT",
            "country_code": "US",
            "postal_code": "847702951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Trace Walker
• Alec Eldon Wall, PT
• Raquel Wall, NURSE PRACTITIONER
• Daycee Wallace
• Henry Wallace
• Steven Henry Wallenfels
• Taylor Rose Wallick
• Brett S. Wallin, M.D
• Jordan Lee Wallin, M.D.
• Walmart Inc.

• Clinical Social Worker in St George, UT
• Providers in St George, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.

Verify at the official NPI Registry.