Individual provider Active NPI

Tawana P Tucker, LICSW

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1336459114
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC302832 Issued in DC
Practice address
1011 N Capitol St NE
Washington, DC 20002-4236
Phone
(202) 898-5293
Fax
(202) 898-5250
NPI assigned
Oct 14, 2010
Last updated
Oct 14, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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 LC302832 DC Primary

Addresses

Primary practice location

1011 N Capitol St NE
Washington, DC 20002-4236

Mailing address

1011 N Capitol St NE
Washington, DC 20002-4236
Phone (202) 898-5293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20040804000861 DC Practitioner - Clinical Social Worker 5193796928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Juspen Behavioral AssociatesGroup PAC ID 8426485152, 5 clinicians

Practice addresses (Care Compare)

11703 Amer CT
Fort Washington, MD 20744-5953

5210 Auth Rd
Suite 205
Camp Springs, MD 20746-4347
Phone (301) 702-0047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Juspen Behavioral Associates. CurrentSince Oct 1, 2021 Accepting new patients
Juspen Enterprises Incorportated Past Accepting new patients

Locations

5210 Auth Rd
Ste 205
Suitland, MD 20746
Phone (240) 375-6512

Organizations & group practices 2

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": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1336459114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N CAPITOL ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200024236",
            "telephone_number": "202-898-5293",
            "fax_number": "202-898-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N CAPITOL ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200024236",
            "telephone_number": "202-898-5293",
            "fax_number": "202-898-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "TAWANA",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-14",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC302832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.