Active NPI
Michelle Renee Tucker, MSW
- Clinical Social Worker
- Columbia, MD
National Provider Identifier
1790710432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 12379
- Practice address
- 6618 Waning Moon Way Apt 732
Columbia, MD 21045-4948 - Phone
- (443) 300-6260
- NPI assigned
- Jul 11, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 12379 | MD | Primary |
Addresses
Primary practice location
6618 Waning Moon Way Apt 732
Columbia, MD 21045-4948
Mailing address
6618 Waning Moon Way Apt 732
Columbia, MD 21045-4948
Phone (443) 300-6260
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 600007429 | Other | MD | MAGELLEN HEALTHCARE |
| 11605292 | Other | MH | CAQH |
| 010052800 | Medicaid | MD |
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 |
|---|---|---|---|
| 12379 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Century Mental Health, Inc. | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Columbia, MD
- NPI 1750402715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754956800000",
"number": "1790710432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6618 WANING MOON WAY APT 732",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210454948",
"telephone_number": "443-300-6260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6618 WANING MOON WAY APT 732",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210454948",
"telephone_number": "443-300-6260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "MICHELLE",
"middle_name": "RENEE",
"name_prefix": "Ms.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2025-08-12",
"certification_date": "2025-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "12379",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLEN HEALTHCARE",
"identifier": "600007429",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11605292",
"state": "MH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010052800",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.