Individual provider Active NPI

Wavey Louise Tuck, LCSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1659651743
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-33583 Issued in ID
Practice address
1409 W Main St Ste 120
Boise, ID 83702-5215
Phone
(406) 480-5800
NPI assigned
Aug 22, 2011
Last updated
Mar 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LMSW-30598 ID
Clinical Social Worker 1041C0700X LCSW-33583 ID Primary

Addresses

Primary practice location

1409 W Main St Ste 120
Boise, ID 83702-5215

Mailing address

1409 W Main St Ste 120
Boise, ID 83702-5215
Phone (406) 480-5800

Other identifiers 1

IdentifierTypeStateIssuer
1659651743MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20161027000863 ID Practitioner - Clinical Social Worker 2668750530 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-30598IDMDSocial Worker
LCSW-33583IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Regional Medical Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1659651743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 W MAIN ST STE 120",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025215",
            "telephone_number": "406-480-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 W MAIN ST STE 120",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025215",
            "telephone_number": "406-480-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCK",
        "first_name": "WAVEY",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-30598",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-33583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659651743",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.