Monique Camille Tucker

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301017206 Issued in MI

Practice address

1777 Axtell Dr
Troy, MI 48084-4404

Phone

(248) 613-5377

NPI assigned

Sep 8, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Awakening Xperience LLC

  • Clinical Psychologist
  • Detroit, MI
  • NPI 1114879954
  NPD Authorized official
• Awakening Xperience Psychological Services

  • Psychologist
  • Farmington Hills, MI
  • NPI 1295418960
  NPD Authorized official

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504828800000",
    "number": "1699293811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30497 SALISBURY ST",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365341",
            "telephone_number": "313-221-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 AXTELL DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844404",
            "telephone_number": "248-613-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MONIQUE",
        "middle_name": "CAMILLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2017-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301017206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trustiva Health Co
• Ian Scott Tschirhart, LMSW
• Michael Tsimis, M.D.
• John F Tu, MD
• Jaclyn Tucker, MA, NCSP, TLLP
• Michael William Tuffo, PA-C
• Turn the Corner Counseling PLLC
• Crystal Turner
• Jackson E Turner Jr., PH.D.
• Linnea Sheri Turner

• Clinical Psychologist in Troy, MI
• Providers in Troy, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2017; 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.