Active NPI
Kyle Stephen Tucker, LMSW
- Social Worker
- Surprise, AZ
National Provider Identifier
1306501648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LMSW-15716
- Practice address
- 13975 West Grand Ave
#101
Surprise, AZ 85374 - Phone
- (623) 266-8490
- Fax
- (623) 398-6094
- NPI assigned
- Nov 2, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW-15716 | AZ | Primary |
Addresses
Primary practice location
13975 West Grand Ave
#101
Surprise, AZ 85374
Mailing address
650 E Indian School Rd
Phoenix, AZ 85012-1839
Phone (690) 223-4712
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 |
|---|---|---|---|
| LMSW-15716 | AZ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750636800000",
"number": "1306501648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 E INDIAN SCHOOL RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850121839",
"telephone_number": "690-223-4712",
"fax_number": "602-217-1478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13975 WEST GRAND AVE",
"address_2": "#101",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "85374",
"telephone_number": "623-266-8490",
"fax_number": "623-398-6094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "KYLE",
"middle_name": "STEPHEN",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-02",
"last_updated": "2025-06-23",
"certification_date": "2025-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AZ",
"license": "LMSW-15716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.