Individual provider Active NPI

Linzie Tuck, BCBA

  • Behavior Analyst
  • Fort Wayne, IN
National Provider Identifier
1417494170
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-17-25702 Issued in IN
Practice address
601 Noble Dr
Fort Wayne, IN 46825
Phone
(260) 420-9332
NPI assigned
Jan 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0167543 IN
Behavior Analyst 103K00000X 1-17-25702 IN Primary

Addresses

Primary practice location

601 Noble Dr
Fort Wayne, IN 46825

Mailing address

601 Noble Dr Ste 20
Fort Wayne, IN 46825-5544
Phone (260) 420-9332

Other practice location 1

3030 Lake Ave
Suite 20
Fort Wayne, IN 46805-5428
Phone (260) 420-9332

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

LicenseStateTypeSpecialty
0167543INMDAssistant Behavior Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Autism Behavior Analyst CurrentSince Dec 15, 2024 Accepting new patients

Locations

3030 Lake Ave
Ste 20
Fort Wayne, IN 46805
Phone (260) 420-9332

601 Noble Dr
Ste 20
Fort Wayne, IN 46825

601 Noble Dr
Fort Wayne, IN 46825
Phone (260) 420-9332

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1417494170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 NOBLE DR STE 20",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255544",
            "telephone_number": "260-420-9332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 NOBLE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46825",
            "telephone_number": "260-420-9332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Lake Ave",
            "address_2": "Suite 20",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468055428",
            "country_code": "US",
            "telephone_number": "260-420-9332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCK",
        "first_name": "LINZIE",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "IN",
            "license": "0167543",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-17-25702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.