Individual provider Active NPI

William C Tucker, LMSW ACSW

  • Clinical Social Worker
  • Marquette, MI
National Provider Identifier
1447219910
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801060344
Practice address
375 N McClellan Ave Ste D
Marquette, MI 49855-5710
Phone
(906) 226-3556
Fax
(888) 551-2613
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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 6801060344 Primary

Addresses

Primary practice location

375 N McClellan Ave Ste D
Marquette, MI 49855-5710

Mailing address

375 N McClellan Ave Ste D
Marquette, MI 49855-5710
Phone (906) 226-3556

Other practice location 1

401 North Third Street
Suite B
Marquette, MI 49855
Phone (906) 226-3556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220125001867 MI Practitioner - Clinical Social Worker 9436541414 Practice locations: Marquette, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

375 N McClellan Ave
Suite D
Marquette, MI 49855-5710

375 N McClellan Ave D
Bill Tucker MSW
Marquette, MI 49855-5710
Phone (906) 226-3566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1447219910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 N MCCLELLAN AVE STE D",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498555710",
            "telephone_number": "906-226-3556",
            "fax_number": "888-551-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 N MCCLELLAN AVE STE D",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498555710",
            "telephone_number": "906-226-3556",
            "fax_number": "888-551-2613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 North Third Street",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Marquette",
            "state": "MI",
            "postal_code": "49855",
            "country_code": "US",
            "telephone_number": "906-226-3556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "credential": "LMSW ACSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "6801060344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.