Individual provider Active NPI

Steven D. Tucker, LCSW

  • Clinical Social Worker
  • Grants Pass, OR
National Provider Identifier
1497058663
Registry record updated Aug 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L2734 Issued in OR
Practice address
777 NE 7TH St
Suite 204
Grants Pass, OR 97526-1632
Phone
(541) 450-7417
NPI assigned
Dec 10, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2012

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 L2734 OR Primary

Addresses

Primary practice location

777 NE 7TH St
Suite 204
Grants Pass, OR 97526-1632

Mailing address

777 NE 7TH St
Suite 204
Grants Pass, OR 97526-1632
Phone (541) 450-7417

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344038400000",
    "number": "1497058663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 NE 7TH ST",
            "address_2": "SUITE 204",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261632",
            "telephone_number": "541-450-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 NE 7TH ST",
            "address_2": "SUITE 204",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261632",
            "telephone_number": "541-450-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "STEVEN",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-10",
        "last_updated": "2012-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L2734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2012; 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.