Active NPI
Imani Tucker, LSW
- Social Worker
- Wooster, OH
National Provider Identifier
1508458407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.2005745
- Practice address
- 2000 Noble Dr
Wooster, OH 44691-5353 - Phone
- (330) 264-3232
- NPI assigned
- Feb 11, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2005745 | OH | |
| Social Worker | 104100000X | S.2005745 | OH | Primary |
Addresses
Primary practice location
2000 Noble Dr
Wooster, OH 44691-5353
Mailing address
2000 Noble Dr
Wooster, OH 44691-5353
Phone (330) 264-3232
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
| License | State | Type | Specialty |
|---|---|---|---|
| S.2005745 | OH | MD | Social Worker |
| 2005745 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1508458407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 NOBLE DR",
"city": "WOOSTER",
"state": "OH",
"postal_code": "446915353",
"telephone_number": "330-264-3232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 NOBLE DR",
"city": "WOOSTER",
"state": "OH",
"postal_code": "446915353",
"telephone_number": "330-264-3232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "IMANI",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-11",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "2005745",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.2005745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wooster, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.