Roseanne Tucker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

094949 Issued in NY

Practice address

12 Washington St
Fort Edward, NY 12828-1734

Phone

(914) 755-9911

NPI assigned

Oct 5, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1386241230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MORGANS LN",
            "city": "COMSTOCK",
            "state": "NY",
            "postal_code": "128211812",
            "telephone_number": "914-755-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 WASHINGTON ST",
            "city": "FORT EDWARD",
            "state": "NY",
            "postal_code": "128281734",
            "telephone_number": "914-755-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "ROSEANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-05",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Sweeter
• The Golub Corporation
• Michael Joseph Tower, OT, CHT
• Town of Fort Edward Union Free School District
• Rachel Alexandra Truax
• Barbara Elizabeth Tyler, RN
• Brenda M Van Wie, M.A. C.C.C.-SLP
• Bernardo R Villajuan, MD
• Leonard A Waite, RPH
• Washington County Ofa

• Clinical Social Worker in Fort Edward, NY
• Providers in Fort Edward, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.