Individual provider Active NPI

Sharon Payne Tucker, LICSW

  • Clinical Social Worker
  • Florence, AL
National Provider Identifier
1316317969
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4208C Issued in AL
Practice address
635 W College St
Florence, AL 35630-5313
Phone
(256) 764-3431
Fax
(256) 768-7462
NPI assigned
Sep 25, 2015
Last updated
Oct 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4208C AL Primary

Addresses

Primary practice location

635 W College St
Florence, AL 35630-5313

Mailing address

635 W College St
Florence, AL 35630-5313
Phone (256) 764-3431

Other practice location 1

205 Jackson Ave S
Russellville, AL 35653-2233
Phone (256) 332-3971

Other identifiers 1

IdentifierTypeStateIssuer
4208COtherALTHE STATE OF AL BOARD OF SOCIAL WORK EXAMINERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181227002065 AL Practitioner - Clinical Social Worker 1557606225 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Center for Mental Health CurrentSince Sep 26, 2018 Accepting new patients

Locations

635 W College St
Florence, AL 35630
Phone (256) 764-3431

205 Jackson Ave S
Russellville, AL 35653
Phone (256) 332-3971

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1316317969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 W COLLEGE ST",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356305313",
            "telephone_number": "256-764-3431",
            "fax_number": "256-768-7462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 W COLLEGE ST",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356305313",
            "telephone_number": "256-764-3431",
            "fax_number": "256-768-7462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Jackson Ave S",
            "address_purpose": "LOCATION",
            "city": "Russellville",
            "state": "AL",
            "postal_code": "356532233",
            "country_code": "US",
            "telephone_number": "256-332-3971",
            "fax_number": "256-332-0799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "SHARON",
        "middle_name": "PAYNE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-25",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4208C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE STATE OF AL BOARD OF SOCIAL WORK EXAMINERS",
            "identifier": "4208C",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

Verify at the official NPI Registry.