Nichole Violet Tucker, LCSW

Individual provider Active NPI Clinical Social Worker · Lakeside Park, KY

NPI 1457072399 · NPPES record last updated Sep 8, 2022

Key facts

NPI
1457072399
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
257213 (KY)
Practice address
2128 Chamber Center Dr
Lakeside Park, KY 41017-1669
Phone
(859) 331-6525
NPI assigned
Sep 8, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
257213KYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 257213 KY Yes

Addresses

Primary practice location

2128 Chamber Center Dr
Lakeside Park, KY 41017-1669

Mailing address

937 Carters Chapel Rd
De Mossville, KY 41033-7502
Phone (859) 816-6734

Other providers in Lakeside Park, KY

All providers in Lakeside Park, KY · Clinical Social Worker in Kentucky

Sources for this page

Verify at the official NPI Registry.