Individual provider Active NPI

Janice P. Tuckman, LICSW

  • Clinical Social Worker
  • Wellesley Hills, MA
National Provider Identifier
1578639571
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
102146 Issued in MA
Practice address
11 Chapel PL
Wellesley Hills, MA 02481-3130
Phone
(781) 235-4950
Fax
(781) 235-7176
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 102146 MA Primary

Addresses

Primary practice location

11 Chapel PL
Wellesley Hills, MA 02481-3130

Mailing address

11 Chapel PL
Wellesley Hills, MA 02481-3130
Phone (781) 235-4950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 8, 2018 through Jan 8, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
102146MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578639571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CHAPEL PL",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024813130",
            "telephone_number": "781-235-4950",
            "fax_number": "781-235-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CHAPEL PL",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024813130",
            "telephone_number": "781-235-4950",
            "fax_number": "781-235-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKMAN",
        "first_name": "JANICE",
        "middle_name": "P.",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "102146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley Hills, MA

Sources for this page

Verify at the official NPI Registry.