Jeffrey Tucker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05762700 Issued in NJ

Practice address

2130 Millburn Ave
Maplewood, NJ 07040-3725

Phone

(646) 382-7410

NPI assigned

Jan 28, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Breakthrough Therapy and Resources

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Newark, NJ
  • NPI 1407612435
  NPD Authorized official
• Children 1St

  • In Home Supportive Care Agency
  • Newark, NJ
  • NPI 1225524606
  NPD Authorized official

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1225629694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 874",
            "city": "HILLSIDE",
            "state": "NJ",
            "postal_code": "072050874",
            "telephone_number": "646-382-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 MILLBURN AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403725",
            "telephone_number": "646-382-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JEFFREY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05762700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0663123",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Hillside",
            "affiliation": "N",
            "address_1": "2130 Millburn Ave",
            "city": "Maplewood",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070403725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Together We Bloom, a NJ Nonprofit Corporation
• Topf'S Maplewood Pharmacy
• Township of Maplewood
• Vatsal Trivedi
• Danielle Tropea, IBCLC
• Khaliah Tutt, LMT
• Twinkle Hearts Empowerment Residence
• TWP of Maplewood Health Dept
• Tyefun Social Services Inc
• Esther O Udechukwu, RDN

• Clinical Social Worker in Maplewood, NJ
• Providers in Maplewood, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.